EP3558400B1 - Water-containing hydrogels for dressing wounds - Google Patents
Water-containing hydrogels for dressing wounds Download PDFInfo
- Publication number
- EP3558400B1 EP3558400B1 EP17825217.7A EP17825217A EP3558400B1 EP 3558400 B1 EP3558400 B1 EP 3558400B1 EP 17825217 A EP17825217 A EP 17825217A EP 3558400 B1 EP3558400 B1 EP 3558400B1
- Authority
- EP
- European Patent Office
- Prior art keywords
- wound
- layer
- hydrogel
- terminated prepolymer
- weight
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F13/00—Bandages or dressings; Absorbent pads
- A61F13/02—Adhesive bandages or dressings
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F13/00—Bandages or dressings; Absorbent pads
- A61F13/02—Adhesive bandages or dressings
- A61F13/0203—Adhesive bandages or dressings with fluid retention members
- A61F13/0206—Adhesive bandages or dressings with fluid retention members with absorbent fibrous layers, e.g. woven or non-woven absorbent pads or island dressings
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F13/00—Bandages or dressings; Absorbent pads
- A61F13/02—Adhesive bandages or dressings
- A61F13/0203—Adhesive bandages or dressings with fluid retention members
- A61F13/0213—Adhesive bandages or dressings with fluid retention members the fluid retention member being a layer of hydrocolloid, gel forming material
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L15/00—Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
- A61L15/16—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
- A61L15/22—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons containing macromolecular materials
- A61L15/225—Mixtures of macromolecular compounds
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L15/00—Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
- A61L15/16—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
- A61L15/22—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons containing macromolecular materials
- A61L15/26—Macromolecular compounds obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds; Derivatives thereof
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L15/00—Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
- A61L15/16—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
- A61L15/42—Use of materials characterised by their function or physical properties
- A61L15/60—Liquid-swellable gel-forming materials, e.g. super-absorbents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L26/00—Chemical aspects of, or use of materials for, wound dressings or bandages in liquid, gel or powder form
- A61L26/0009—Chemical aspects of, or use of materials for, wound dressings or bandages in liquid, gel or powder form containing macromolecular materials
- A61L26/0019—Chemical aspects of, or use of materials for, wound dressings or bandages in liquid, gel or powder form containing macromolecular materials obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L26/00—Chemical aspects of, or use of materials for, wound dressings or bandages in liquid, gel or powder form
- A61L26/0009—Chemical aspects of, or use of materials for, wound dressings or bandages in liquid, gel or powder form containing macromolecular materials
- A61L26/0052—Mixtures of macromolecular compounds
Definitions
- the subject matter of the present invention comprises water-containing hydrogels for the treatment of wounds.
- the healing of skin wounds is based on the skin's ability to regenerate epithelium and connective and supporting tissue.
- the regeneration itself is characterized by a complex process of interlocking cell activities that gradually advance the healing process.
- the literature describes three essential healing phases of a wound, particularly in the case of wounds with tissue loss. This includes the inflammatory (inflammatory) or exudative phase for hemostasis and wound cleaning (phase 1, cleaning phase), the proliferative phase for building granulation tissue (phase 2, granulation phase) and the differentiation phase for epithelialization and scar formation (phase 3, epithelialization phase). It has been shown that healing of the wound is particularly promoted by moist wound treatment.
- wound dressings made of various materials can be used, among other things.
- necrosis and pathological microorganisms can have a negative effect on the physiological metabolism during the wound healing process. This can often lead to local hypoxia, which can then result in further degradation of the surrounding tissue. This breakdown of the surrounding tissue can, in turn, additionally hinder wound healing, which can lead to chronic wounds.
- chronic wounds are wounds that do not heal within an expected period of 4 to 6 weeks.
- the wound is not treated optimally, scars can remain.
- the affected tissue is only impaired by the scars from a cosmetic point of view, but not in its effectiveness. Otherwise it is also possible that the scarred tissue loses its functional properties, such as its elasticity and sensitivity.
- Water-based hydrogels are successfully used as a component of wound dressings in the moist treatment of wounds. They are able to absorb exudate emerging from the wound into the gel matrix and to release moisture from the gel matrix, so that the wound is provided with an environment that promotes wound healing. Often they represent the wound contact layers of wound dressings. In the course of the time in which the wound dressings lie on the wound to be treated, the absorption capacity and the moisture release capacity are exhausted, so that the wound dressings containing a water-based hydrogel have to be changed several times until the wound has healed completely .
- a dressing change represents a critical situation for the patient because the dressing can carry away components of the wound tissue or the sensitive skin surrounding the wound that adhere to the dressing.
- a composition is advantageous which is able to bind harmful factors in the wound exudate and thus remove them from the wound tissue, as well as to concentrate components of the wound exudate that promote wound healing and thus make them available to the wound tissue in a higher concentration.
- wound dressings should be comfortable for the patient to wear and restrict the freedom of movement of the affected body parts as little as possible in order not to adversely affect the patient's adherence to therapy.
- EP630629 discloses water-containing hydrogel matrices comprising a polyurethane-polyurea copolymer and propylene glycol for wound treatment.
- WO2010 / 000450 and WO2010 / 000451 disclose foam-containing wound dressings with a water-containing hydrogel matrix comprising a polyurethane-polyurea copolymer.
- EP2338528 and EP2338529 disclose water-containing hydrogel matrices comprising a polyurea-polyurethane copolymer and propylene glycol with improved absorption or adhesive properties.
- wound healing can still be improved in the above method.
- constituent propylene glycol has been identified as disadvantageous.
- the known wound dressings can also lead to skin irritation and can still be optimized with regard to the patient's adherence to therapy.
- the aim of the present invention is to overcome the disadvantages of the prior art.
- the object is to provide the use of substances in the treatment of wounds which lead to improved wound healing.
- the substances or the wound care products containing these substances should be perceived by the patient as pleasant, have good tolerance for wound tissue and skin and lead to advantageous adherence to therapy.
- This wound care product should be able to be applied as required in all phases of wound healing in order to ensure the above-mentioned effect.
- a wound is usually present when the tissue connection has been severed on an outer or inner surface of the body.
- a primarily healing wound is understood to be a wound with non-gaping wound edges, which is characterized by uncomplicated healing without infection. These wounds often occur in parts of the body that are well supplied with blood. The wound edges, which are not gaping and therefore close to one another, may have been caused, for example, by a (surgical) cut. If there is no further treatment, the wound closes without complications. Further wounds are the secondary healing wounds.
- a secondary healing wound is understood to be a wound if a) there is a loss of tissue and / or b) contamination has occurred which prevents primary healing. The organism can compensate for the loss of tissue through newly formed tissue and skin. In the context of secondary wound healing, this leads to the formation of granulation tissue through to scarred replacement of the tissue gap.
- the secondary healing wound is a mechanical wound, a thermal wound, a wound caused by chemical substances or by radiation.
- Mechanical wounds can occur as a result of external violence. These include, for example, cuts, stab wounds, lacerations, bruises, abrasions, scratches, bites and gunshot wounds.
- Thermal wounds are mainly caused by strong heat or exposure to cold. These include, for example, burns, scalds, frostbite and injuries caused by electrical current.
- Chemical wounds are burns. These can be caused, for example, by acidic, alkaline, oxidizing and / or reducing substances.
- Wounds caused by radiation are also known as actinic wounds. These are triggered, for example, by ionizing radiation and can have an appearance similar to burn wounds.
- Chronic wounds can be defined as wounds whose healing process deviates from normal wound healing in one or all stages of wound healing.
- Acute, normally healing wounds can develop into a chronic wound, for example due to a wound infection, which is characterized by a delayed healing rate. The transition from an acute to a chronic wound can take place at any stage of wound healing.
- Clinically, chronic wounds are defined as wounds whose Need more than 6-8 weeks to heal, although this definition does not correctly cover all clinical pictures. Chronic wounds are more of a diagnosis based on the clinical experience of the medical staff.
- Chronic wounds arise in particular due to mechanical stress (pressure ulcers, pressure ulcers), venous insufficiency (venous leg ulcers, venous ulcers), arteriosclerotic vascular changes (arterial leg ulcers, arterial ulcers), neuropathic changes (diabetic foot syndrome, neuropathic changes Ulcers), but also as a result of autoimmune diseases, tumors (ulcerating tumors) or radiation damage during tumor therapy.
- the pressure ulcer is defined as trophic disruption of tissues (especially skin and subcutaneous tissue) with necrosis, maceration, possibly infection, caused by external (long-term) pressure with compression of vessels and local ischemia. Decubitus ulcers occur primarily when bedridden, especially on parts of the body where the skin is in direct contact with the bone, but also, for example, under ill-fitting prostheses and casts that are too tight.
- the pressure ulcer is divided into the following stages. Chronic wounds in particular are level II, level III and level IV pressure ulcers: Pressure ulcer - level I: This is a persistent, circumscribed reddening of the skin that remains even when the pressure is relieved. The reddening is sharply demarcated and can be hardened or overheated. The skin is still intact.
- Decubitus ulcer - stage II In this phase blistering and abrasion of the skin occur and thus partial loss of the skin. The epidermis up to parts of the dermis is damaged. At this stage there is a superficial wound or shallow ulcer.
- Decubitus - Stage III In this advanced stage, a loss of all skin layers can already be observed. In addition, damage to the subcutaneous tissue and possibly necrosis can be observed, which can extend to the underlying muscle tissue. Experience has shown that the necrotic tissue must first be delimited before the full extent of the tissue damage can be seen. The pressure ulcer III shows up clinically as an open, deep ulcer.
- Pressure ulcers - Stage IV In this extremely critical stage, loss of all skin layers with extensive destruction, tissue necrosis or damage to muscles, bones or supporting structures (tendons, joint capsules) is recorded. The pressure ulcer IV shows up clinically as a large, open and deep ulcer.
- the inflammatory phase usually occurs immediately after the trauma and lasts about three days. It is characterized by vascular contraction, activation of the coagulation cascade and complex immunological processes. As a rule, a fibrin network forms, which closes the wound and protects it from the outside. The release of vasoactive substances (e.g. histamine and serotonin) can cause a local inflammatory reaction.
- vasoactive substances e.g. histamine and serotonin
- the surrounding vessels can widen and the increased capillary permeability allows leukocytes to migrate to the site of inflammation. These can eliminate microorganisms and tissue necrosis. This allows the wound to be cleaned.
- the subsequent proliferation or granulation phase usually begins around the second day after the wound has formed and can last for up to 14 days, for example.
- New tissue is built up with vascular sprouting and the defect filling with granulation tissue. This is the basic requirement for the subsequent epithelialization.
- Fibroblasts from the surrounding tissue can migrate into the fibrin network and use it as a temporary matrix.
- the build-up of collagen fibers begins.
- the fibrin structure can be broken down by the enzyme plasmin by means of fibrinolysis.
- the closed vessels can be recanalized.
- the maturation of the collagen fibers usually begins with the differentiation or remodeling phase, approximately between the sixth and tenth day.
- the wound contracts by converting fibroblasts into fibrocytes and myofibroblasts. This causes the scar tissue to shrink and the wound to shrink.
- the epithelialization from the edge of the wound brings the wound healing to a conclusion.
- the treatment of the wounds is a phase-appropriate wound treatment.
- phase-appropriate wound therapy is understood to mean that the wound therapy addresses the specific needs of the wound in the individual phases.
- phase-appropriate treatment can take place in one or more phases of wound healing. (In contrast, with conventional wound treatments, one and the same treatment takes place over all phases).
- hydrogel denotes a finely dispersed system composed of at least one solid and one liquid phase.
- This solid phase forms a sponge-like, three-dimensional network, the pores of which are filled with a liquid (lyogel) or a gas (xerogel). Both phases preferably penetrate one another completely.
- a hydrogel can preferably be constructed from a synthetic or natural material, preferably from a hydrophilic synthetic material.
- hydrogel is also referred to synonymously below as hydrogel composition or hydrogel matrix.
- the present invention has a polymer containing polyurethane and polyurea groups as the solid phase.
- percentages that relate to the concentration of ingredients are understood to denote the proportion of the starting materials mentioned in the overall reaction mixture of prepolymers, water, polyhydric alcohol and, if applicable, salt.
- Hydrogels which can be used as water-containing hydrogels in connection with the present invention are in particular hydrogels which form a cohesive, discrete layer and do not release any water under a pressure which occurs when the hydrogel is used as intended.
- the present invention relates to water-containing hydrogels for treating wounds obtainable by reacting a) amine-terminated prepolymer containing polyalkylene oxide units with a b) isocyanate-terminated prepolymer containing polyalkylene oxide units, the reaction being carried out in the presence of a polyhydric alcohol, with the exception of propylene glycol, and in the presence of water takes place and based on the total mass of all reactants the sum of the masses of amine-terminated Prepolymer and isocyanate-terminated prepolymer is 10-30% by weight of the total mass of all reactants and the mass of the polyhydric alcohol, with the exception of propylene glycol, is 5-35% by weight of the total mass of all reactants and the mass of the water used is at least 40% by weight.
- the molar ratio of reactive isocyanate end groups to reactive amine end groups being 1.0 to 2.0, preferably 1.0 to 1.8, particularly preferably 1.0 to 1.6, very particularly preferably 1.0 to 1.5, most preferably 1.2 to 1.3, characterized in that the polyhydric alcohol is glycerol.
- the invention relates to a water-containing hydrogel for treating wounds obtainable by reacting a) amine-terminated prepolymer containing polyalkylene oxide units with a b) isocyanate-terminated prepolymer containing polyalkylene oxide units, the reaction being carried out in the presence of a polyhydric alcohol, with the exception of propylene glycol, and takes place in the presence of water and, based on the total mass of all reactants, the sum of the masses of amine-terminated prepolymer and isocyanate-terminated prepolymer is 15-25% by weight of the total mass of all reactants and the mass of the polyhydric alcohol, with the exception of propylene glycol, 5 -35% by weight of the total mass of all reactants and the mass of the water used is at least 40% by weight of the total mass of all reactants, the molar ratio of reactive isocyanate end groups to reactive amine end groups being 1.0 to 2.0, preferably 1.0 to 1.8, particularly preferably 1.0
- the hydrogel can be obtained by reacting an amine-terminated prepolymer containing polyethylene oxide and / or polypropylene oxide units with an at least three-armed branched isocyanate-terminated prepolymer containing polyethylene oxide and / or polypropylene oxide units in the presence of a polyhydric alcohol, with the exception of propylene glycol, the molar ratio being more reactive Isocyanate end groups to reactive amine end groups 1.0 to 2.0, preferably 1.0 to 1.8, particularly preferably 1.0 to 1.6, very particularly preferably 1.0 to 1.5, most preferably 1.2 to 1 , 3 is.
- the hydrogel can be obtained by reacting an amine-terminated prepolymer containing polyethylene oxide and polypropylene oxide units with an at least three-armed branched isocyanate-terminated prepolymer containing polyethylene oxide and polypropylene oxide units in the presence of a polyhydric alcohol, with the exception of propylene glycol, the ratio of reactive isocyanate end groups to reactive amine end groups 1.0 to 2.0, preferably 1.0 to 1.8, particularly preferably 1.0 to 1.6, very particularly preferably 1.0 to 1.5, most preferably 1.2 to 1.3 and wherein the weight ratio of polyethylene oxide to polypropylene oxide units both in the amine-terminated prepolymer and in the isocyanate-terminated prepolymer is 3: 1 to 7: 1.
- a typical amine-terminated prepolymer is, for example, a triblock polymer composed of propylene glycol, ethylene glycol and again propylene glycol units, the polymer being terminally amine-functionalized with 2-aminopropyl groups. It has a content of reactive amine end groups of 0.9554 mmol / g with an average molecular weight of about 2000 g / mol and a dispersity of 1.08, measured by gel permeation chromatography, and a molar ratio of ethylene units to propylene units of 3: 1 to 7: 1, preferably 39: 6.
- Such an amine-terminated prepolymer is commercially available, for example, as Jeffamin® ED-2003, Huntsman; Everberg, Belgium.
- a typical isocyanate-terminated prepolymer with aliphatic diisocyanate groups is, for example, a three-armed copolymer of propylene glycol and polyethylene glycol units, each of which has been reacted at the end with a molecule of isophorone diisocyanate. It has a content of reactive isocyanate end groups (NCO groups) of 3.0% to 3.4%, preferably 3.2%, and a molar ratio of ethylene oxide units to propylene oxide units of 3: 1 to 4: 1.
- NCO groups reactive isocyanate end groups
- Such an isocyanate-terminated prepolymer with aliphatic diisocyanate groups is commercially available, for example, as Aquapol® PL-13000-3 (Carpenter; Richmond, USA).
- hydrogel which is obtainable by reacting said amine-terminated prepolymer Jeffamin® ED-2003 with said isocyanate-terminated Aquapol® PL-13000-3 in the presence of a polyhydric alcohol, with the exception of propylene glycol, the mass ratio of Aquapol to Jeffamine is between 1.0 and 2.5, preferably between 1.1 and 1.7.
- hydrogels are particularly suitable for storing water and delivering this water to a wound.
- the solid phase is not formed solely by a polymer that results from the reaction between an amine-terminated prepolymer and an isocyanate-terminated prepolymer.
- a polyhydric alcohol with the exception of propylene glycol, is also involved in the reaction, the free hydroxyl groups of which can react with isocyanate groups.
- the polyhydric alcohol component contributes to an additional crosslinking which, in particular in the case of polyhydric alcohols with more than two hydroxyl groups, leads to a three-dimensional crosslinking of the prepolymers.
- the reaction between a polyhydric alcohol and an isocyanate group produces a carbamic acid ester, which is also known as urethane.
- This reaction can be accelerated by using acids or bases as a catalyst and can be reversed with the addition of thermal energy. If the reaction temperature is kept constant between 5 ° C. and 30 ° C., preferably between 5 ° C. and 20 ° C., this reaction can take place in a sufficient ratio so that hydrogels with covalently bound polyhydric alcohols are obtained which have advantageous properties.
- Hydrogels according to the invention also contain glycerol.
- This alcohol is excellently suited as a moisturizer and thus represents a caring component for the skin surrounding the wound.
- Hydrogels which contain this alcohol as a partner in the reactions described above have a high absorption capacity for wound exudate and a reduced loss of moisture. They have an adhesive force that allows an atraumatic dressing change. Due to their low cytotoxicity, they are very well tolerated by wound tissue. In addition, such gels are able to concentrate the wound exudate growth factors necessary for wound healing and thus accelerate wound healing. This is particularly true for glycerol-containing hydrogels.
- glycerol is used as the polyhydric alcohol in a concentration of 10-25% by weight.
- Such hydrogels have particularly advantageous properties with regard to cell compatibility, fluid loss and adhesion.
- glycerol is used as the polyhydric alcohol in a concentration of 15-25% by weight.
- Such hydrogels also have a particularly high absorption capacity.
- a hydrogel according to the invention contains at least 40% by weight and very particularly preferably at least 50% by weight of water, the hydrogel further preferably comprising at most 90% by weight and furthermore preferably at most 80% by weight of water. It is thus possible to provide a hydrogel for wound treatment which provides an amount of moisture sufficient for natural wound healing.
- the water-containing hydrogel matrix in particular comprises at least one salt.
- the hydrogel matrix comprises an inorganic salt. Chlorides, iodides, sulfates, hydrogen sulfates, carbonates, hydrogen carbonates, phosphates, dihydrogen phosphates or hydrogen phosphates of the alkali and alkaline earth metals are particularly suitable in this connection.
- the hydrogel matrix preferably comprises sodium chloride, potassium chloride, magnesium chloride, calcium chloride or mixtures thereof. Sodium chloride is particularly preferred. These salts simulate the electrolyte mixture in a wound serum released by a wound in a particularly good way. A hydrogel matrix comprising these salts thus provides a wound with a climate that is particularly conducive to wound healing.
- the hydrogel matrix comprises 0 to 5% by weight of at least one salt.
- the hydrogel matrix comprises 0.1 to 3% by weight of a salt and very particularly preferably 0.5 to 1.5% by weight of a salt.
- Hydrogels according to the invention are suitable for the treatment of wounds. They can be distributed as semi-solid, plastically deformable masses on a wound surface by means of suitable application devices. Suitable application devices are, for example, tubes or adapted syringes.
- Hydrogels according to the invention are preferably part of a wound dressing.
- a wound pad is understood to mean a product which is applied to a wound and is made available in ready-to-use form.
- Suitable wound dressings have at least one layer made of a carrier material and one layer comprising a hydrogel according to the invention.
- polymer films or polymer foams can be used as the carrier layer, preferably films or foams made from polyurethane, polyether urethane, polyester urethane, polyether-polyamide copolymers, polyacrylate or polymethacrylate.
- a water-impermeable and water-vapor-permeable polyurethane film or a water-impermeable and water-vapor-permeable polyurethane foam is suitable as the carrier layer.
- a polyurethane film, polyester urethane film or polyether urethane film is preferred as the polymer film.
- polymer films which have a thickness of 15 ⁇ m to 50 ⁇ m, in particular 20 ⁇ m to 40 ⁇ m and very particularly preferably 25 ⁇ m to 30 ⁇ m are also very particularly preferred.
- the water vapor permeability of the polymer film of the wound dressing is preferably at least 750 g / m 2 / 24h, in particular at least 1000 g / m 2 / 24h and very particularly preferably at least 2000 g / m 2 / 24h (measured according to DIN EN 13726).
- these films have a moisture-proof, adhesive edge section. This edge section ensures that the wound system can be applied and fixed at its intended location.
- the absorbent layer comprises a hydrophilic polyurethane foam and the hydrogel.
- a hydrophilic polyurethane foam can be impregnated or coated with the hydrogel or completely or partially penetrated by this.
- the hydrogel composition can also be present adjacent to or spatially separated from the absorbent layer.
- the hydrogel composition for example comprising a polyurethane-polyurea copolymer, can be coated on a surface of a layer of a polyurethane foam so that a hydrogel layer comprising the hydrogel composition rests in direct contact on a layer of polyurethane foam.
- the hydrogel layer and the absorbent layer can also be separated from one another by a spacer layer.
- the spacer layer can comprise a hydrogel matrix, a polymer film, a hydrocolloid matrix, a polymer network, a textile fabric, an adhesive and / or a polymer network.
- the multilayer wound dressing can also comprise further layers in addition to the absorbent layer and the carrier layer, such as, for example, a wound contact layer, one or more barrier layers and / or one or more distribution layers.
- Preferred wound dressings comprise a carrier layer, a hydrogel layer according to the present invention and, optionally, an absorbent layer arranged between the hydrogel layer and the carrier layer.
- the absorbent layer can preferably comprise a fiber material, particularly preferably a hydrophilic polyurethane foam.
- the hydrogel layer can be continuous or discontinuous. It can, for example, be applied over the entire surface of the carrier layer or have channels, holes or other shaped openings. In the case of a discontinuous hydrogel layer, a multiplicity of discrete hydrogel elements can be applied to the carrier layer and / or to the absorbent layer, which elements can have the shape of circles, squares or other regular or irregular polygons.
- the wound dressings also have a high level of comfort for the patient in that they are easy to use, skin-friendly, soft, thin, skin-conforming and analgesic (via a hydrogel cooling effect) and can therefore also be used over a long period of time, usually 3 to 5 days before changing the dressing.
- the carrier material can be coated with an adhesive over the entire surface or partially, continuously or discontinuously.
- a hydrogel according to the invention can be applied directly to a carrier layer. It can also be used with the help of an adhesive better cohesion. Further layers can be arranged between the carrier layer and the hydrogel layer. It has been found to be advantageous if a wound dressing has a layer as an additional layer which is capable of absorbing, storing and / or distributing liquid within the layer or transferring it to further layers. Suitable layers which are able to absorb liquids are nonwoven materials made of natural or synthetic fibers or mixtures thereof, open-pore foam materials or materials which contain a hydrophobic matrix in which particles which absorb liquids are contained. An open-cell foam material made of polyurethane is preferred.
- a wound care product according to the invention preferably comprises a hydrophilic polyurethane foam.
- a hydrophilic polyurethane foam is advantageous for rapid wound healing because such foams have a high absorption capacity and are therefore preferably used in the cleaning phase of wound healing in the case of heavy exudation.
- Another advantage of polyurethane foams is that only low shear forces are exerted on a wound to be treated and the wound is thus well padded.
- a hydrophilic polyurethane foam is understood to mean a polyurethane foam which can take up and store a liquid in its polyurethane matrix and in its pores, thus absorb it, and release at least part of the taken up liquid again.
- Open-pored, hydrophilic polyurethane foams are particularly suitable as hydrophilic polymer foams.
- a particularly preferred wound dressing comprises a layer which comprises an open-pored, hydrophilic polyurethane foam.
- polyurethane foams should preferably be used which have a high absorption capacity for liquids of more than 2.5 g, preferably more than 10 g, even more preferably more than 16 g of isotonic salt solution per gram of foam polymer. The absorption capacity is determined according to DIN EN 13726-1: 2002 (3 min measurement). Such a foam can absorb germs and cell debris and safely enclose it, but still lie soft, supple and with a good cushioning effect on the wound.
- the hydrophilic polyurethane foam preferably has an average pore size of less than 1000 ⁇ m, in particular 100 to 1000 ⁇ m, preferably 100 to 500 ⁇ m and very particularly preferably 100 to 300 ⁇ m.
- the preferred method of determining pore size is to measure the diameter of a plurality of pores on one Section plane which is oriented parallel to the wound contact side of the foam layer or the wound care product. The measurement of the pore size can be done by looking at the pores in a light or electron microscope and comparing the pore diameter with a suitable scale.
- the foam can have a homogeneous pore size or a gradient of the pore size over the thickness of the foam layer.
- a reduction in the pore size starting from the wound contact layer from larger pores on the wound contact side (mean pore size e.g. 200-300 ⁇ m) to smaller pores on the one facing away from the wound during use Side of the foam (mean pore size, for example 100-200 ⁇ m) ensures efficient drainage of wound exudate.
- An efficient drainage of wound exudate results because a capillary effect can be generated for particularly good absorption of liquids.
- the foam can provide a sufficient amount of moisture for a wound.
- a foam with a pore size gradient across the thickness of the foam and a pore size of less than 1000 ⁇ m is used, for example, in the product Permafoam from Paul Hartmann AG.
- the wound dressing also has a water-vapor-permeable polyurethane cover layer.
- the water vapor permeable polyurethane top layer has a water vapor permeability ("upright", measured according to DIN EN 13726-2 at a temperature of 37 ° C.) of more than 600 g / m 2 in 24 h.
- the wound dressing has a reticulated hydrogel on the wound side. It is also advantageous if the wound dressing comprises a polyurethane cover layer away from the wound.
- the foam has a density of 70 to 110 kg / m3.
- a hydrophobic PU foam with a density of 10 to 50 kg / m 3 can be used.
- foams are used in particular in wound dressings which are intended for negative pressure therapy of wounds.
- silicone foams it would also be conceivable and advantageous to use silicone foams with a density of up to 300 kg / m 3.
- Polyurethane foams are usually obtainable by reacting a curable mixture, comprising the components polyisocyanate and compounds reactive toward isocyanate, in particular polyol, as well as catalysts, blowing agents and optionally Additives.
- a curable mixture comprising the components polyisocyanate and compounds reactive toward isocyanate, in particular polyol, as well as catalysts, blowing agents and optionally Additives.
- polyisocyanate in particular polyo
- diphenylmethane diisocyanate in particular 4,4'-diphenylmethane diisocyanate, mixtures of monomeric diphenylmethane diisocyanates and higher nuclear homologues of diphenylmethane diisocyanate, tetramethylene diisocyanate, hexamethylene diisocyanate, tolylene diisocyanate or mixtures thereof are suitable for producing the polyurethanes.
- Isocyanate-reactive compounds are usually polyols such as polyetherols and / or polyesterols.
- Foam wound dressings which comprise a polyurethane foam whose layer thickness is 0.1 cm to 1.8 cm, preferably from 0.3 cm to 1.5 cm and very particularly preferably from 0.5 cm to 1, have also been shown to be particularly advantageous designs. 0 cm.
- the layer thickness can be the same at every point on the wound contact layer or assume different values in different areas of the wound contact layer.
- the absorbent layer or the polyurethane foam has flattened edges.
- the wound care product preferably has an essentially square basic shape. A size range of 8 cm x 8 cm up to 20 cm x 20 cm is particularly preferred.
- the thickness of the wound care product is preferably less than 2 cm, the foam layer preferably having a thickness between 0.1 cm and 1.8 cm.
- an additional material can be used as the wound contact layer.
- a wound contact layer is in direct contact with the wound when the wound dressing according to the invention is used.
- the only purpose of the wound contact layer is to space the foam away from the wound to be treated.
- the additional layer has the advantage of ensuring that the wound care product is removed in a manner that is particularly gentle on the tissue when the dressing is changed.
- the wound contact layer can perform further functions in relation to the wound to be treated.
- the wound contact layer can supply the wound with moisture, have wound edge care properties, reduce skin irritation or have an antiadherent effect.
- a wound dressing according to the invention can have a wound contact layer, the wound contact layer comprising a hydrogel, a polymer film, a hydrocolloid matrix, a polymer mesh, a nonwoven and / or an adhesive.
- hydrogel or gel In the context of the invention, denotes a finely dispersed system composed of at least one solid and one liquid phase. This solid phase forms a spongy, three-dimensional network, the pores of which are filled by a liquid (lyogel) or a gas (xerogel). Both phases penetrate each other completely.
- a hydrophilic polyurethane foam with a water content of at least 10 wt. Comprises% water, wherein the water can be released from the polymer foam or the polyurethane foam.
- the proportion of water that may be used for formation is not to be understood. This water is covalently bound and is not available for wound treatment.
- a proportion of water that is used for production reasons in the manufacture of the foam is also not to be understood.
- a wound dressing according to the invention thus has a polymer foam or a polyurethane foam which comprises a water content which clearly exceeds a residual water content possibly caused by the production after drying.
- a wound dressing according to the invention preferably comprises a hydrophilic polyurethane foam which has a retention value R of at least 20%. It is furthermore preferably provided here that the hydrophilic polyurethane foam has a retention value R of at least 30%, in particular of at least 40%, in particular at least 40% and very particularly preferably of at least 50%. Independently of this, it can furthermore preferably be provided that the wound dressing has a hydrophilic polyurethane foam which has a retention value R of at most 90%, in particular of at most 80% and very particularly of at most 70%. The retention value R is determined according to a method described herein.
- a wound pad according to the invention very particularly preferably comprises a hydrophilic polyurethane foam which has a water content of at least 10% by weight, the water content corresponding to the retention value R of the polyurethane foam.
- the hydrogel can be used in different ways to treat wounds.
- the gel can be applied to the wound first and then covered with a wound pad.
- Another possibility of using the gel for wound treatment is to use a wound dressing that holds the hydrogel in a wound contact layer. In this way, the pH stabilizing properties of the gel in the acidic range are provided in the wound.
- Wound dressings that comprise a hydrogel matrix with a layer thickness of 0.1 to 5.0 mm have also been shown to be particularly advantageous embodiments.
- a wound dressing according to the invention thus has a wound contact layer with a layer thickness of 0.1 to 5.0 mm, in particular 0.5 to 5.0 mm and very particularly preferably 0.5 to 3.0 mm.
- Wound dressings with such layer thicknesses show, on the one hand, no wound adhesion and, on the other hand, the ability to absorb wound exudate released by a wound and to pass it on to the absorbent layer. These layer thicknesses can be the same at every point on the wound contact layer or assume different values in different areas of the wound contact layer.
- the hydrogel matrix can preferably comprise channels, in particular conical channels, for the passage of liquids from the first to the second side.
- channels in particular conical channels, for the passage of liquids from the first to the second side.
- the channels have an elliptical or circular cross-section, ie that the channels have a circular or elliptical opening on both the first and the second side of the hydrogel matrix, the circular or elliptical opening on the first and the second side are of different sizes.
- the channels have a triangular, rectangular, square, pentagonal, hexagonal or other polygonal cross section.
- the first side has openings which are larger in comparison to the opening located on the second side.
- the wound contact layer or the hydrogel matrix has openings which have a diameter of 0.5 to 5 mm.
- the wound contact layer or the hydrogel matrix has openings which have a diameter of 1 to 3 mm.
- the wound contact layer or the hydrogel matrix very particularly preferably has openings on the first side facing the wound that have a diameter of 1 to 3 mm have, wherein the second side of the wound contact layer or the hydrogel matrix is in direct contact with the polyurethane foam.
- a transition layer is arranged between the absorbent layer and the wound contact layer.
- a wound dressing according to the invention has a layer between the hydrogel matrix and polyurethane foam which comprises both materials.
- this transition layer can have channels, openings or holes. If the transition layer has channels, openings or holes, according to a further preferred embodiment, these channels, openings or holes are filled with polyurethane foam. Furthermore, these channels, openings or holes are preferably congruent to the channels, openings or holes in the wound contact layer.
- the hydrogels according to the invention are suitable for the treatment of wounds.
- the present invention therefore also comprises hydrogels according to the invention for treating wounds.
- the present invention comprises hydrogels for the treatment of chronic wounds such as pressure ulcers, pressure ulcers, pressure ulcers, venous leg ulcers, venous ulcers, arterial leg ulcers, arterial ulcers, wounds as a result of diabetic foot syndrome, neuropathic ulcers, but also wounds as a result of autoimmune diseases or from tumors (ulcerating tumors) or from radiation damage during tumor therapy.
- Hydrogels or wound dressings according to the invention which contain them are suitable for phase-appropriate wound therapy, in particular for the therapy of wounds in the granulation phase and / or the epithelialization phase.
- a first wound dressing (10) according to the invention is shown with a view of the wound contact layer.
- the wound pad (10) is made as a so-called island dressing and consists of a carrier layer (11) made of a water-impermeable and water-vapor-permeable polyurethane film, which is coated over the entire surface with an acrylate adhesive (12).
- an absorbent, hydrophilic polyurethane foam layer is applied by means of the acrylate adhesive (12) (not shown here), to which a hydrogel (15) according to the invention is applied as a wound contact layer.
- the hydrophilic polyurethane foam layer has a water content of 40% by weight of water.
- 100 g of a polyurethane foam used in this example comprises 40 g of water and 60 g of polyurethane matrix.
- the hydrogel wound contact layer (15) is adhesively connected to the absorbent polyurethane foam layer (not shown here).
- a multiplicity of circular holes (16) are made in the hydrogel wound contact layer in order to allow wound exudate to flow from the wound into the absorbent layer.
- the hydrogel wound contact layer prevents newly formed cells from growing into the pores of the polyurethane foam.
- the wound dressing (20) comprises a carrier layer (21) congruent with an absorbent layer (23) and made of a water-impermeable and water-vapor-permeable polyurethane foam, which is connected to the absorbent layer (23) by means of a discontinuous adhesive layer (22) made of an acrylate adhesive.
- a discontinuous adhesive layer (22) made of an acrylate adhesive.
- areas (27) of the absorbent layer and the carrier layer remain unconnected.
- the wound pad comprises an absorbent layer (23) with a layer thickness of 4 mm and a carrier layer (21) with a layer thickness of 1.5 mm.
- the absorbent layer (23) is formed from an open-pored hydrophilic polyurethane foam which has an average pore size of 220 ⁇ m.
- the polyurethane foam has a water content of 70% by weight.
- a hydrogel according to the invention is applied as a wound contact layer (25) to the first side of the polyurethane foam.
- the hydrogel with a surface weight of 75 g / m 2 is not applied continuously to the polyurethane foam, so that circular holes (26) are provided in the hydrogel wound contact layer (25) for improved passage of wound exudate.
- the polyurethane foam comprises a first side with an area of 25 cm 2 , the holes (26) occupying a total area of 5 cm 2.
- the wound dressing (30) comprises a carrier layer (31) made of a water-impermeable and water vapor permeable polyurethane film, an absorbent layer (33) made of an open-pored hydrophilic polyurethane foam with a water content of 52.8% by weight (based on the polyurethane foam) and a wound contact layer (35) made of a hydrogel according to the invention with a water content of approx. 57.9 % By weight on (based on the hydrogel).
- the carrier layer (31) is laminated over the entire surface to the hydrophilic polymer foam by means of an acrylate adhesive (32) applied to the polymer film.
- a water-containing hydrogel (35) which comprises a polyurethane-polyurea copolymer, is applied to the first side of the absorbent layer, which faces the wound when in use.
- the hydrogel wound contact layer is equipped with conical channels (36) with a circular cross-section (parallel to the wound) so that an improved wound exudate flow can take place from the wound into the absorbent hydrophilic foam (cf. Figure 3a ).
- the still viscous hydrogel penetrated slightly into the polyurethane foam, so that a transition layer (34) consisting of the hydrogel and the hydrophilic polyurethane foam is formed between the hydrogel wound contact layer and the hydrophilic polyurethane foam.
- the transition layer for its part, has channels (37) which are only filled with polyurethane foam and which are arranged congruently to the channels in the hydrogel wound contact layer.
- the wound dressing (40) comprises a carrier layer (41) made of a water-impermeable and water-vapor-permeable polyurethane film, a layer (42) made of water-containing hydrogel according to the invention and a two-part cover layer (43) made of siliconized paper.
- the hydrogel layer has a thickness of 3mm.
- the masses of the constituents used in the reaction to produce the gels have the ratios given in Table 2 based on the total mass of the reactants used: Table 2: Mass ratios of the reactants used Example no. Jeffamin ED-2003 Aquapol PL- 13000-3 alcohol Demin.
- Example No. 12 is a comparative example without polyhydric alcohol.
- Example no. 13 is a comparative example according to WO2010 / 000451 .
- moisture loss The loss of weight over a certain period of time at a defined temperature is described as moisture loss.
- the term adhesive force describes the ability of an adhesive to adhere to a surface. It corresponds to the force that is necessary to detach a body that has come into contact with the gel surface from this surface and is determined with the aid of a static materials testing machine Zwick 010.
- the gels must be conditioned under the test conditions for 24 hours before the test. For each measurement, three samples each with a size of 5 cm x 5 cm are punched out of the gels. The samples are attached to the side facing away from the wound with double-sided adhesive tape on a horizontally movable slide.
- the approach speed of the slide is 100 mm / min, the contact time with the gel surface 2 s, the withdrawal speed of the slide 400 mm / min.
- hydrogels were delivered sterile in Petri dishes.
- 0.1 g / ml culture medium each of the samples was weighed out.
- the cell activity, the number of cells and the protein concentration were examined three times per sample in four parallel batches each.
- the elution time was 48 hours and the incubation of the cells with the eluates was also 48 hours.
- DMEM Dulbecco's mod. Eagle Medium
- VA BioLab 042901 was used as the culture medium for preculture and elution.
- the cells were sown at a concentration of 50,000 cells / ml, preculturing took place at 37 ° C. and 5% CO2 for 24 h.
- the DMEM medium added during sowing was then drawn off and the cells were each covered with 1 ml of eluate at a concentration of 100%.
- DMEM medium was incubated for 48 h in a 50 ml Falcon tube like the samples; the eluate of the plastic discs in a concentration of 100% served as a positive control. After 48 hours of incubation, the cell activity, the number of cells and the total protein content were determined.
- the cells were counted after enzymatic detachment of the cells by means of Accutase with the aid of the cell counter.
- WST 1 tetrazolium salt
- OD absorption values
- the protein content is tested using the DC Protein Assay, from BIO-RAD GmbH Munich, according to the manufacturer's instructions.
- the protein determination according to Lowry is based on the reduction of Cu (II) to Cu (I) by the aromatic tyrosine-tryptophan residues of proteins.
- the copper-protein complex is reduced in a further step Phosphomolybdic acid phosphotungstate reagent for molybdenum or tungsten blue. The extinction of this intense blue color is measured photometrically at 750 nm.
- the protein concentration can be determined by carrying a standard series.
- a cell activity of 0-29% is characterized as a strongly reduced metabolic activity, a cell activity of 30-59% as a moderately reduced metabolic activity and a cell activity of 60-79% compared to the control as a weakly reduced metabolic activity.
- Cell activity rates between 80 and 100% indicate a non-reduced metabolic activity.
- a protein concentration of 0-34% is characterized as a strongly reduced protein content, and a protein concentration of 35-69% as a moderately reduced protein content compared to the control. Protein concentrations between 70 and 100% indicate a non-reduced protein content.
- Table 5 Cell Compatibility Example no. sample Cell growth inhibition Decrease in metabolic activity Reduction in protein content 1 Glycerol 5% Weak Moderate Moderate 2 Glycerol 10% weak Weak No 3 Glycerol 15% Weak Weak No 4th Glycerol 20% Weak Weak No 5 Glycerol 25% Weak Weak No 6th Glycerol 30% moderate weak no 7th Ethylene glycol 20% Moderate moderate Moderate 8th Sorbitol 20% Moderate strong Moderate 9 Sucrose 20% Weak moderate No 10 PEG300 20% strong Strong Moderate 11 PEG2000 20% moderate moderate Moderate 12th H2O weak weak Moderate 13th Propylene glycol 20% Strong Strong Moderate
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Description
Der Gegenstand der vorliegenden Erfindung umfasst wasserhaltige Hydrogele zur Behandlung von Wunden.The subject matter of the present invention comprises water-containing hydrogels for the treatment of wounds.
Die Heilung von Hautwunden beruht auf der Fähigkeit der Haut, Epithel sowie Binde- und Stützgewebe zu regenerieren. Die Regeneration selbst ist durch ein komplexes Geschehen ineinander übergreifender Zellaktivitäten gekennzeichnet, die den Heilungsprozess schrittweise vorantreiben. So werden in der Literatur drei wesentliche Heilungsphasen einer Wunde, insbesondere bei Wunden mit Gewebeverlust, beschrieben. Hierzu gehört die Entzündungs- (inflammatorische) oder exsudative Phase zur Blutstillung und Wundreinigung (Phase 1, Reinigungsphase), die proliferative Phase zum Aufbau von Granulationsgewebe (Phase 2, Granulationsphase) und die Differenzierungsphase zur Epithelisierung und Narbenbildung (Phase 3, Epithelisierungsphase). Es hat sich gezeigt, dass eine Abheilung der Wunde durch eine feuchte Wundbehandlung besonders gefördert wird. Im Rahmen einer Wundbehandlung können unter anderem Wundauflagen aus verschiedenen Materialien eingesetzt werden.The healing of skin wounds is based on the skin's ability to regenerate epithelium and connective and supporting tissue. The regeneration itself is characterized by a complex process of interlocking cell activities that gradually advance the healing process. The literature describes three essential healing phases of a wound, particularly in the case of wounds with tissue loss. This includes the inflammatory (inflammatory) or exudative phase for hemostasis and wound cleaning (phase 1, cleaning phase), the proliferative phase for building granulation tissue (phase 2, granulation phase) and the differentiation phase for epithelialization and scar formation (phase 3, epithelialization phase). It has been shown that healing of the wound is particularly promoted by moist wound treatment. As part of a wound treatment, wound dressings made of various materials can be used, among other things.
Es ist bekannt, dass es bei der Wundheilung zu Störungen kommen kann. Im Falle einer gestörten Wundheilung können Nekrosen und pathologische Mikroorganismen auf den physiologischen Metabolismus während des Wundheilungsgeschehens negativ einwirken. Dies kann häufig zu lokaler Hypoxie führen, was dann in einem weiteren Abbau des umliegenden Gewebes resultieren kann. Dieser Abbau des umliegenden Gewebes kann wiederum die Wundheilung zusätzlich behindern, wobei chronische Wunden entstehen können. Als chronische Wunden werden im Rahmen dieser Erfindung Wunden bezeichnet, die nicht in einem erwarteten Zeitraum von 4 bis 6 Wochen verheilen.It is known that disturbances in wound healing can occur. In the event of impaired wound healing, necrosis and pathological microorganisms can have a negative effect on the physiological metabolism during the wound healing process. This can often lead to local hypoxia, which can then result in further degradation of the surrounding tissue. This breakdown of the surrounding tissue can, in turn, additionally hinder wound healing, which can lead to chronic wounds. In the context of this invention, chronic wounds are wounds that do not heal within an expected period of 4 to 6 weeks.
Weiterhin können bei der nicht optimalen Behandlung von Wunden Narben zurückbleiben. Im günstigen Fall wird das betroffene Gewebe durch die Narben nur aus kosmetischer Sicht aber nicht in seiner Wirkungsweise beeinträchtigt. Andernfalls ist es aber auch möglich, dass das vernarbte Gewebe funktionelle Eigenschaften, wie seine Elastizität und Empfindlichkeit, einbüßt.Furthermore, if the wound is not treated optimally, scars can remain. In the best case, the affected tissue is only impaired by the scars from a cosmetic point of view, but not in its effectiveness. Otherwise it is also possible that the scarred tissue loses its functional properties, such as its elasticity and sensitivity.
Aus Wunden tritt ein Exsudat aus, das eine komplexe Zusammensetzung aufweist. Es enthält dabei sowohl wachstumsfördernde Substanzen als auch den Gewebeaufbau erschwerender Substanzen, deren gegensätzliche Wirkungen entscheidenden Einfluss auf den Wundheilungsverlauf haben.Exudate, which has a complex composition, emerges from wounds. It contains both growth-promoting substances and substances that aggravate tissue build-up, the opposing effects of which have a decisive influence on the wound healing process.
Wasserhaltige Hydrogele werden als Bestandteil von Wundverbänden erfolgreich in der feuchten Behandlung von Wunden eingesetzt. Sie sind in der Lage, aus der Wunde austretendes Wundexsudat in die Gelmatrix aufzunehmen und Feuchtigkeit aus der Gelmatrix abzugeben, so dass der Wunde ein die Wundheilung förderndes Milieu zur Verfügung gestellt wird. Häufig stellen sie die Wundkontaktschichten von Wundverbänden dar. Im Laufe der Zeit, in der die Wundauflagen auf der zu behandelnden Wunde aufliegen, werden dabei die Absorptionskapazität und das Feuchtigkeitsabgabevermögen erschöpft, so dass die ein wasserhaltiges Hydrogel enthaltenden Wundverbände bis zur vollständigen Wundheilung mehrfach gewechselt werden müssen. Ein Verbandwechsel stellt dabei für den Patienten eine kritische Situation dar, weil mit dem Verband am Verband anhaftende Bestandteile des Wundgewebes oder der empfindlichen, die Wunde umgebenden Haut mitgerissen werden können. Um den Verbandwechsel so wenig traumatisch wie möglich gestalten zu können, werden besondere Anforderungen an die Wundkontaktschicht gestellt. So darf das Anhaftungsvermögen des Hydrogels an Wundgewebe und/oder Haut nicht zu groß sein, obwohl ein initiales Anhaften des Hydrogels beim Auflegen der Wundauflage zur besseren Fixierbarkeit durchaus gewünscht ist.Water-based hydrogels are successfully used as a component of wound dressings in the moist treatment of wounds. They are able to absorb exudate emerging from the wound into the gel matrix and to release moisture from the gel matrix, so that the wound is provided with an environment that promotes wound healing. Often they represent the wound contact layers of wound dressings. In the course of the time in which the wound dressings lie on the wound to be treated, the absorption capacity and the moisture release capacity are exhausted, so that the wound dressings containing a water-based hydrogel have to be changed several times until the wound has healed completely . A dressing change represents a critical situation for the patient because the dressing can carry away components of the wound tissue or the sensitive skin surrounding the wound that adhere to the dressing. In order to be able to make the dressing change as less traumatic as possible, special requirements are placed on the wound contact layer. Thus, the ability of the hydrogel to adhere to wound tissue and / or skin must not be too great, although initial adhesion of the hydrogel when the wound dressing is applied is absolutely desirable for better fixability.
Weiterhin ist es zur Aufrechterhaltung eines wundheilungsfördernden Milieus wünschenswert, eine zellkompatible Hydrogelzusammensetzung zur Verfügung zu stellen. Vorteilhaft ist eine Zusammensetzung, die in der Lage ist, schädliche Faktoren des Wundexsudats zu binden und so von dem Wundgewebe zu entfernen, sowie wundheilungsfördernde Komponenten des Wundexsudats aufzukonzentrieren und so dem Wundgewebe in höherer Konzentration zur Verfügung zu stellen.Furthermore, in order to maintain an environment that promotes wound healing, it is desirable to provide a cell-compatible hydrogel composition. A composition is advantageous which is able to bind harmful factors in the wound exudate and thus remove them from the wound tissue, as well as to concentrate components of the wound exudate that promote wound healing and thus make them available to the wound tissue in a higher concentration.
Schließlich sollen Wundauflagen für den Patienten angenehm zu tragen sein und möglichst wenig die Bewegungsfreiheit der betroffenen Körperteile einschränken, um die Therapietreue des Patienten nicht nachteilig zu beeinflussen.Finally, wound dressings should be comfortable for the patient to wear and restrict the freedom of movement of the affected body parts as little as possible in order not to adversely affect the patient's adherence to therapy.
Es hat sich jedoch heraus gestellt, dass sowohl die Wundheilung in dem oben stehenden Verfahren noch verbesserungsfähig ist. Insbesondere der Bestandteil Propylenglykol wurde als nachteilig identifiziert. Auch können die bekannten Wundauflagen zu Hautirritationen führen und sind im Hinblick auf die Therapietreue der Patienten noch optimierbar.However, it has been found that both wound healing can still be improved in the above method. In particular, the constituent propylene glycol has been identified as disadvantageous. The known wound dressings can also lead to skin irritation and can still be optimized with regard to the patient's adherence to therapy.
Es besteht ein ständiges Interesse daran, Mittel bereitzustellen, die die genannten Anforderungen besser erfüllen. Der Gegenstand des Anspruchs 1 löst diese Aufgabe.There is a constant interest in providing means that better meet the requirements mentioned. The subject matter of claim 1 solves this problem.
Ziel der vorliegenden Erfindung ist es, die Nachteile aus dem Stand der Technik zu überwinden.The aim of the present invention is to overcome the disadvantages of the prior art.
Insbesondere liegt die Aufgabe zugrunde, die Verwendung von Substanzen in der Behandlung von Wunden zur Verfügung zu stellen, welche zu einer verbesserten Wundheilung führen. Die Substanzen beziehungsweise die diese Substanzen enthaltenden Wundversorgungsprodukte sollen vom Patienten als angenehm empfunden werden, eine gute Verträglichkeit für Wundgewebe und Haut aufweisen und zu einer vorteilhaften Therapietreue führen.In particular, the object is to provide the use of substances in the treatment of wounds which lead to improved wound healing. The substances or the wound care products containing these substances should be perceived by the patient as pleasant, have good tolerance for wound tissue and skin and lead to advantageous adherence to therapy.
Somit ist es eine Aufgabe der vorliegenden Erfindung, ein verbessertes Wundversorgungsprodukt bereitzustellen, das den pathologischen Zustand einer Wunde derart beeinflusst, dass ein schneller Wundheilungsverlauf stattfinden kann. Dieses Wundversorgungsprodukt soll bedarfsgerecht in allen Phasen der Wundheilung angebracht werden können, um den oben genannten Effekt zu gewährleisten.It is therefore an object of the present invention to provide an improved wound care product which influences the pathological condition of a wound in such a way that the wound healing process can take place more quickly. This wound care product should be able to be applied as required in all phases of wound healing in order to ensure the above-mentioned effect.
Im Sinne dieser Erfindung liegt üblicherweise eine Wunde vor, wenn an einer äußeren oder inneren Körperoberfläche der Gewebezusammenhang getrennt wurde.For the purposes of this invention, a wound is usually present when the tissue connection has been severed on an outer or inner surface of the body.
Es gibt unterschiedliche Arten von Wunden. So wird unter einer primär heilenden Wunde eine Wunde mit nicht klaffenden Wundrändern verstanden, welche sich durch komplikationslose Heilung ohne Infektion auszeichnet. Diese Wunden kommen häufig in gut durchbluteten Körperteilen vor. Die nicht klaffenden und damit eng aneinander liegenden Wundränder können beispielsweise durch einen (chirurgischen) Schnitt verursacht worden sein. Erfolgt keine weitere Behandlung schließt sich die Wunde komplikationslos.
Weitere Wunden sind die sekundär heilenden Wunden. Unter einer sekundär heilenden Wunde wird eine Wunde verstanden, wenn a) ein Verlust des Gewebes vorliegt und/oder b) eine Verkeimung eingetreten ist, welche die primäre Heilung verhindert. Den Verlust an Gewebe kann der Organismus durch neu zu bildendes Gewebe und Überhäutung ausgleichen. Dies führt im Rahmen der sekundären Wundheilung über die Bildung eines Granulationsgewebes bis zum narbigen Ersatz der Gewebslücke.There are different types of wounds. Thus, a primarily healing wound is understood to be a wound with non-gaping wound edges, which is characterized by uncomplicated healing without infection. These wounds often occur in parts of the body that are well supplied with blood. The wound edges, which are not gaping and therefore close to one another, may have been caused, for example, by a (surgical) cut. If there is no further treatment, the wound closes without complications.
Further wounds are the secondary healing wounds. A secondary healing wound is understood to be a wound if a) there is a loss of tissue and / or b) contamination has occurred which prevents primary healing. The organism can compensate for the loss of tissue through newly formed tissue and skin. In the context of secondary wound healing, this leads to the formation of granulation tissue through to scarred replacement of the tissue gap.
In einer bevorzugten Ausführungsform der vorliegenden Erfindung ist die sekundär heilende Wunde eine mechanische Wunde, eine thermische Wunde, eine durch chemische Substanzen oder durch Strahlung verursachte Wunde.In a preferred embodiment of the present invention, the secondary healing wound is a mechanical wound, a thermal wound, a wound caused by chemical substances or by radiation.
Durch äußere Gewalteinwirkung können mechanische Wunden entstehen. Hierzu zählen beispielsweise Schnitt-, Stich-, Platz-, Quetsch-, Schürf-, Kratz-, Biss- und Schusswunden.Mechanical wounds can occur as a result of external violence. These include, for example, cuts, stab wounds, lacerations, bruises, abrasions, scratches, bites and gunshot wounds.
Thermische Wunden werden im Wesentlichen durch starke Wärme oder Kälteeinwirkung verursacht. Hierzu zählen beispielsweise Verbrennungen, Verbrühungen, Erfrierungen sowie durch elektrischen Strom verursachte Verletzungen.Thermal wounds are mainly caused by strong heat or exposure to cold. These include, for example, burns, scalds, frostbite and injuries caused by electrical current.
Unter chemischen Wunden werden Verätzungen verstanden. Diese können beispielsweise durch saure, alkalische, oxidierende und/oder reduzierende Substanzen verursacht werden.Chemical wounds are burns. These can be caused, for example, by acidic, alkaline, oxidizing and / or reducing substances.
Durch Strahlung verursachte Wunden werden auch als aktinische Wunden bezeichnet. Diese werden beispielsweise durch ionisierende Strahlung ausgelöst und können ein ähnliches Erscheinungsbild wie Verbrennungswunden aufweisen.Wounds caused by radiation are also known as actinic wounds. These are triggered, for example, by ionizing radiation and can have an appearance similar to burn wounds.
Chronische Wunden können definiert werden als Wunden, deren Heilungsverlauf in einem oder allen Stadien der Wundheilung von der normalen Wundheilung abweichen. So kann aus akuten, normal heilenden Wunden z.B. durch eine Wundinfektion eine chronische Wunde entstehen, die durch eine verzögerte Heilungsgeschwindigkeit gekennzeichnet ist. Der Übergang von einer akuten zu einer chronischen Wunde kann dabei in jedem Stadium der Wundheilung erfolgen. Klinisch werden chronische Wunden definiert als Wunden, deren Heilung mehr als 6-8 Wochen benötigen, wobei diese Definition nicht alle Krankheitsbilder korrekt abdeckt. Es handelt sich bei chronischen Wunden mehr um eine Diagnose, die sich auf die klinische Erfahrung des medizinischen Personals stützt.Chronic wounds can be defined as wounds whose healing process deviates from normal wound healing in one or all stages of wound healing. Acute, normally healing wounds can develop into a chronic wound, for example due to a wound infection, which is characterized by a delayed healing rate. The transition from an acute to a chronic wound can take place at any stage of wound healing. Clinically, chronic wounds are defined as wounds whose Need more than 6-8 weeks to heal, although this definition does not correctly cover all clinical pictures. Chronic wounds are more of a diagnosis based on the clinical experience of the medical staff.
Chronische Wunden entstehen insbesondere aufgrund einer mechanischen Belastung (Dekubitus, Druck-Ulzera, Druckgeschwür), einer venösen Insuffizienz (Ulcus cruris venosum, venöse Ulzera), einer arteriosklerotischen Gefäßveränderung (Ulcus cruris arteriosum, arterielle Ulzera), einer neuropathischen Veränderungen (diabetisches Fußsyndrom, neuropathische Ulzera), aber auch in Folge von Autoimmunerkrankungen, von Tumoren (exulzierende Tumore) oder Strahlenschäden bei der Tumortherapie.Chronic wounds arise in particular due to mechanical stress (pressure ulcers, pressure ulcers), venous insufficiency (venous leg ulcers, venous ulcers), arteriosclerotic vascular changes (arterial leg ulcers, arterial ulcers), neuropathic changes (diabetic foot syndrome, neuropathic changes Ulcers), but also as a result of autoimmune diseases, tumors (ulcerating tumors) or radiation damage during tumor therapy.
Der Dekubitus ist definiert als durch äußere (längerfristige) Druckeinwirkung mit Kompression von Gefäßen und lokaler Ischämie hervorgerufene trophische Störung von Geweben (v. a. Haut und Unterhautgewebe) mit Nekrose, Mazeration, evtl. Infektion. Dekubitalulcera entstehen vor allem bei Bettlägerigkeit, insbesondere an Körperstellen, an denen die Haut dem Knochen unmittelbar anliegt, aber auch z.B. unter schlecht sitzenden Prothesen und zu engen Gipsverbänden.The pressure ulcer is defined as trophic disruption of tissues (especially skin and subcutaneous tissue) with necrosis, maceration, possibly infection, caused by external (long-term) pressure with compression of vessels and local ischemia. Decubitus ulcers occur primarily when bedridden, especially on parts of the body where the skin is in direct contact with the bone, but also, for example, under ill-fitting prostheses and casts that are too tight.
Der Dekubitus wird in folgende Stadien eingeteilt. Hierbei sind als chronische Wunden insbesondere Dekubitus der Stufe II, Stufe III und Stufe IV bekannt:
Dekubitus - Stufe I: Hierbei handelt es sich um eine persistierende, umschriebene Hautrötung, die auch bei Entlastung bestehen bleibt. Die Rötung ist scharf umgrenzt und kann verhärten oder überwärmt sein. Die Haut ist noch intakt.The pressure ulcer is divided into the following stages. Chronic wounds in particular are level II, level III and level IV pressure ulcers:
Pressure ulcer - level I: This is a persistent, circumscribed reddening of the skin that remains even when the pressure is relieved. The reddening is sharply demarcated and can be hardened or overheated. The skin is still intact.
Dekubitus - Stufe II: In dieser Phase kommt es zu Blasenbildung und Hautabschürfung und damit zu Teilverlust der Haut. Die Epidermis bis hin zu Anteilen der Dermis ist geschädigt. In dieser Phase liegt eine oberflächige Wunde oder flaches Geschwür vor.Decubitus ulcer - stage II: In this phase blistering and abrasion of the skin occur and thus partial loss of the skin. The epidermis up to parts of the dermis is damaged. At this stage there is a superficial wound or shallow ulcer.
Dekubitus - Stufe III: In diesem fortgeschrittenen Stadium ist bereits ein Verlust aller Hautschichten zu beobachten. Darüber hinaus sind eine Schädigung der subkutanen Gewebe und eventuell Nekrosen zu beobachten, die bis auf das darunter liegende Muskelgewebe reichen können. Erfahrungsgemäß muss es erst zu einer Abgrenzung des nekrotischen Gewebes kommen bis das ganze Ausmaß des Gewebeschadens erkennbar wird. Der Dekubitus III zeigt sich klinisch als offenes, tiefes Geschwür.Decubitus - Stage III: In this advanced stage, a loss of all skin layers can already be observed. In addition, damage to the subcutaneous tissue and possibly necrosis can be observed, which can extend to the underlying muscle tissue. Experience has shown that the necrotic tissue must first be delimited before the full extent of the tissue damage can be seen. The pressure ulcer III shows up clinically as an open, deep ulcer.
Dekubitus - Stufe IV: In diesem äußerst kritischen Stadium ist ein Verlust aller Hautschichten mit ausgedehnter Zerstörung, Gewebsnekrose oder Schädigung von Muskeln, Knochen oder unterstützenden Strukturen (Sehnen, Gelenkkapseln) zu verzeichnen. Der Dekubitus IV zeigt sich klinisch als großflächiges, offenes und tiefes Geschwür.Pressure ulcers - Stage IV: In this extremely critical stage, loss of all skin layers with extensive destruction, tissue necrosis or damage to muscles, bones or supporting structures (tendons, joint capsules) is recorded. The pressure ulcer IV shows up clinically as a large, open and deep ulcer.
Die inflammatorische Phase tritt üblicherweise direkt nach dem Trauma auf und dauert in etwa drei Tage. Sie ist gekennzeichnet durch Gefäßkontraktion, Aktivierung der Gerinnungskaskade und komplexe immunologische Abläufe. Es kommt in der Regel zur Ausbildung eines Fibrinnetzes, welches die Wunde verschließt und nach außen schützt. Durch die Freisetzung vasoaktiver Substanzen (z.B. Histamin und Serotonin) kann eine lokale Entzündungsreaktion hervorgerufen werden. Die umliegenden Gefäße können sich erweitern und durch eine gesteigerte Kapillarpermeabilität können Leukozyten zum Entzündungsort wandern. Diese können Mikroorganismen und Gewebsnekrosen beseitigen. Dadurch kann eine Reinigung der Wunde erfolgen.The inflammatory phase usually occurs immediately after the trauma and lasts about three days. It is characterized by vascular contraction, activation of the coagulation cascade and complex immunological processes. As a rule, a fibrin network forms, which closes the wound and protects it from the outside. The release of vasoactive substances (e.g. histamine and serotonin) can cause a local inflammatory reaction. The surrounding vessels can widen and the increased capillary permeability allows leukocytes to migrate to the site of inflammation. These can eliminate microorganisms and tissue necrosis. This allows the wound to be cleaned.
Die darauffolgende Proliferations- oder Granulationsphase beginnt üblicherweise etwa am zweiten Tag nach der Wundentstehung und kann z.B. bis zu 14 Tage andauern. Es erfolgt der Aufbau von neuem Gewebe mit Gefäßeinsprossung und Defektauffüllung durch Granulationsgewebe. Dies ist die Grundvoraussetzung für die spätere Epithelisierung. Fibroblasten aus dem umliegenden Gewebe können in das Fibrinnetz migrieren und es als provisorische Matrix nutzen. Es beginnt der Aufbau von Kollagenfasern. Durch das Enzym Plasmin kann das Fibringerüst mittels Fibrinolyse abgebaut werden. Die verschlossenen Gefäße können rekanalisiert werden.The subsequent proliferation or granulation phase usually begins around the second day after the wound has formed and can last for up to 14 days, for example. New tissue is built up with vascular sprouting and the defect filling with granulation tissue. This is the basic requirement for the subsequent epithelialization. Fibroblasts from the surrounding tissue can migrate into the fibrin network and use it as a temporary matrix. The build-up of collagen fibers begins. The fibrin structure can be broken down by the enzyme plasmin by means of fibrinolysis. The closed vessels can be recanalized.
Mit der Differenzierungs- oder Umbauphase beginnt, etwa zwischen dem sechsten und zehnten Tag, üblicherweise die Ausreifung der kollagenen Fasern. Die Wunde kontrahiert sich durch die Umwandlung von Fibroblasten in Fibrozyten sowie Myofibroblasten. Dadurch schrumpft das Narbengewebe und es führt zu einer Verkleinerung der Wunde. Die Epithelisierung vom Wundrand her bringt die Wundheilung zum Abschluss.The maturation of the collagen fibers usually begins with the differentiation or remodeling phase, approximately between the sixth and tenth day. The wound contracts by converting fibroblasts into fibrocytes and myofibroblasts. This causes the scar tissue to shrink and the wound to shrink. The epithelialization from the edge of the wound brings the wound healing to a conclusion.
In einer bevorzugten Ausführungsform der vorliegenden Erfindung ist die Behandlung der Wunden, bevorzugt der sekundär heilenden Wunden, eine phasengerechte Wundbehandlung. Unter einer phasengerechten Wundtherapie wird im Rahmen dieser Anmeldung verstanden, dass die Wundtherapie auf die spezifischen Bedürfnisse der Wunde in den einzelnen Phasen eingeht.In a preferred embodiment of the present invention, the treatment of the wounds, preferably the secondary healing wounds, is a phase-appropriate wound treatment. In the context of this application, phase-appropriate wound therapy is understood to mean that the wound therapy addresses the specific needs of the wound in the individual phases.
So kann die phasengerechte Behandlung gezielt in einer oder mehreren Phasen der Wundheilung erfolgen. (Im Gegensatz dazu erfolgt bei herkömmlichen Wundbehandlungen ein und dieselbe Behandlung über alle Phasen).In this way, the phase-appropriate treatment can take place in one or more phases of wound healing. (In contrast, with conventional wound treatments, one and the same treatment takes place over all phases).
Der Begriff Hydrogel bezeichnet dabei im Rahmen der Erfindung ein feindisperses System aus mindestens einer festen und einer flüssigen Phase. Diese feste Phase bildet dabei ein schwammartiges, dreidimensionales Netzwerk, dessen Poren durch eine Flüssigkeit (Lyogel) beziehungsweise auch ein Gas (Xerogel) ausgefüllt sind. Beide Phasen durchdringen sich dabei bevorzugt vollständig. Durch Wasseraufnahme kann das dreidimensionale Netzwerk durch Quellen sein Volumen vergrößern, ohne dabei den strukturellen Zusammenhalt zu verlieren. Ein Hydrogel kann bevorzugt aus einem synthetischen oder natürlichen Material, bevorzugt aus einem hydrophilen synthetischen Material, aufgebaut sein.In the context of the invention, the term hydrogel denotes a finely dispersed system composed of at least one solid and one liquid phase. This solid phase forms a sponge-like, three-dimensional network, the pores of which are filled with a liquid (lyogel) or a gas (xerogel). Both phases preferably penetrate one another completely. By absorbing water, the three-dimensional network can increase its volume through swelling without losing its structural cohesion. A hydrogel can preferably be constructed from a synthetic or natural material, preferably from a hydrophilic synthetic material.
Der Begriff Hydrogel wird im Folgenden auch synonym als Hydrogelzusammensetzung oder Hydrogelmatrix bezeichnet.The term hydrogel is also referred to synonymously below as hydrogel composition or hydrogel matrix.
Die vorliegende Erfindung weist dabei als feste Phase ein Polymer enthaltend Polyurethan- und Polyharnstoffgruppen. Als flüssige Phase dient dabei eine Mischung aus Wasser und mehrwertigem Alkohol, ausgenommen Propylenglykol.The present invention has a polymer containing polyurethane and polyurea groups as the solid phase. A mixture of water and polyhydric alcohol, with the exception of propylene glycol, serves as the liquid phase.
Im Folgenden werden Prozentangaben, die sich auf die Konzentration von Inhaltsstoffen beziehen, so verstanden, dass sie den Anteil der genannten Ausgangsstoffe in der Gesamtreaktionsmischung aus Präpolymeren, Wasser, mehrwertigem Alkohol und ggf. Salz bezeichnen.In the following, percentages that relate to the concentration of ingredients are understood to denote the proportion of the starting materials mentioned in the overall reaction mixture of prepolymers, water, polyhydric alcohol and, if applicable, salt.
Als wasserhaltige Hydrogele können im Zusammenhang mit der vorliegenden Erfindung insbesondere Hydrogele verwendet werden, die eine zusammenhängende, diskrete Schicht bilden und unter einem Druck, der bei bestimmungsgemäßer Anwendung des Hydrogels auftritt, kein Wasser abgeben.Hydrogels which can be used as water-containing hydrogels in connection with the present invention are in particular hydrogels which form a cohesive, discrete layer and do not release any water under a pressure which occurs when the hydrogel is used as intended.
Die vorliegende Erfindung betrifft wasserhaltige Hydrogele zur Behandlung von Wunden erhältlich durch Umsetzung eines a) Amin-terminierten Präpolymers enthaltend Polyalkylenoxideinheiten mit einem b) Isocyanat-terminierten Präpolymer enthaltend Polyalkylenoxideinheiten, wobei die Umsetzung in Gegenwart eines mehrwertigen Alkohols, ausgenommen Propylenglykol, und in Gegenwart von Wasser erfolgt und wobei bezogen auf die Gesamtmasse aller Reaktanden die Summe der Massen aus Amin-terminiertem Präpolymer und Isocyanat-terminiertem Präpolymer 10-30 Gew.-% der Gesamtmasse aller Reaktanden beträgt und die Masse des mehrwertigen Alkohols, ausgenommen Propylenglykol, 5-35 Gew.-% der Gesamtmasse aller Reaktanden beträgt und die Masse des eingesetzten Wasser mindestens 40 Gew.-% der Gesamtmasse aller Reaktanden beträgt, wobei das molare Verhältnis reaktiver Isocyanatendgruppen zu reaktiven Aminendgruppen 1,0 bis 2,0, bevorzugt 1,0 bis 1,8, besonders bevorzugt 1,0 bis 1,6, ganz besonders bevorzugt 1,0 bis 1,5, am meisten bevorzugt 1,2 bis 1,3 dadurch gekennzeichnet, dass es sich bei dem mehrwertigen Alkohol um Glycerol handelt.The present invention relates to water-containing hydrogels for treating wounds obtainable by reacting a) amine-terminated prepolymer containing polyalkylene oxide units with a b) isocyanate-terminated prepolymer containing polyalkylene oxide units, the reaction being carried out in the presence of a polyhydric alcohol, with the exception of propylene glycol, and in the presence of water takes place and based on the total mass of all reactants the sum of the masses of amine-terminated Prepolymer and isocyanate-terminated prepolymer is 10-30% by weight of the total mass of all reactants and the mass of the polyhydric alcohol, with the exception of propylene glycol, is 5-35% by weight of the total mass of all reactants and the mass of the water used is at least 40% by weight. -% of the total mass of all reactants, the molar ratio of reactive isocyanate end groups to reactive amine end groups being 1.0 to 2.0, preferably 1.0 to 1.8, particularly preferably 1.0 to 1.6, very particularly preferably 1.0 to 1.5, most preferably 1.2 to 1.3, characterized in that the polyhydric alcohol is glycerol.
In einer bevorzugten Ausführungsform betrifft die Erfindung ein wasserhaltiges Hydrogel zur Behandlung von Wunden erhältlich durch Umsetzung eines a) Amin-terminierten Präpolymers enthaltend Polyalkylenoxideinheiten mit einem b) Isocyanat-terminierten Präpolymer enthaltend Polyalkylenoxideinheiten, wobei die Umsetzung in Gegenwart eines mehrwertigen Alkohols, ausgenommen Propylenglykol, und in Gegenwart von Wasser erfolgt und wobei bezogen auf die Gesamtmasse aller Reaktanden die Summe der Massen aus Amin-terminiertem Präpolymer und Isocyanat-terminiertem Präpolymer 15-25 Gew.-% der Gesamtmasse aller Reaktanden beträgt und die Masse des mehrwertigen Alkohols, ausgenommen Propylenglykol, 5-35 Gew.-% der Gesamtmasse aller Reaktanden beträgt und die Masse des eingesetzten Wasser mindestens 40 Gew.-% der Gesamtmasse aller Reaktanden beträgt, wobei das molare Verhältnis reaktiver Isocyanatendgruppen zu reaktiven Aminendgruppen 1,0 bis 2,0, bevorzugt 1,0 bis 1,8, besonders bevorzugt 1,0 bis 1,6, ganz besonders bevorzugt 1,0 bis 1,5, am meisten bevorzugt 1,2 bis 1,3 dadurch gekennzeichnet, dass es sich bei dem mehrwertigen Alkohol um Glycerol handelt.In a preferred embodiment, the invention relates to a water-containing hydrogel for treating wounds obtainable by reacting a) amine-terminated prepolymer containing polyalkylene oxide units with a b) isocyanate-terminated prepolymer containing polyalkylene oxide units, the reaction being carried out in the presence of a polyhydric alcohol, with the exception of propylene glycol, and takes place in the presence of water and, based on the total mass of all reactants, the sum of the masses of amine-terminated prepolymer and isocyanate-terminated prepolymer is 15-25% by weight of the total mass of all reactants and the mass of the polyhydric alcohol, with the exception of propylene glycol, 5 -35% by weight of the total mass of all reactants and the mass of the water used is at least 40% by weight of the total mass of all reactants, the molar ratio of reactive isocyanate end groups to reactive amine end groups being 1.0 to 2.0, preferably 1.0 to 1.8, particularly preferably 1.0 to 1.6, very particularly preferably 1.0 to 1.5, most preferably 1.2 to 1.3, characterized in that the polyhydric alcohol is glycerol.
Insbesondere ist das Hydrogel dabei erhältlich durch Umsetzung eines Amin-terminierten Präpolymers enthaltend Polyethylenoxid- und/oder Polypropylenoxideinheiten mit einem mindestens dreiarmig verzweigten Isocyanat-terminierten Präpolymer enthaltend Polyethylenoxid- und/oder Polypropylenoxideinheiten in Gegenwart eines mehrwertigen Alkohols, ausgenommen Propylenglykol, wobei das molare Verhältnis reaktiver Isocyanatendgruppen zu reaktiven Aminendgruppen 1,0 bis 2,0, bevorzugt 1,0 bis 1,8, besonders bevorzugt 1,0 bis 1,6, ganz besonders bevorzugt 1,0 bis 1,5, am meisten bevorzugt 1,2 bis 1,3 beträgt.In particular, the hydrogel can be obtained by reacting an amine-terminated prepolymer containing polyethylene oxide and / or polypropylene oxide units with an at least three-armed branched isocyanate-terminated prepolymer containing polyethylene oxide and / or polypropylene oxide units in the presence of a polyhydric alcohol, with the exception of propylene glycol, the molar ratio being more reactive Isocyanate end groups to reactive amine end groups 1.0 to 2.0, preferably 1.0 to 1.8, particularly preferably 1.0 to 1.6, very particularly preferably 1.0 to 1.5, most preferably 1.2 to 1 , 3 is.
Insbesondere ist das Hydrogel dabei erhältlich durch Umsetzung eines Amin-terminierten Präpolymers enthaltend Polyethylenoxid- und Polypropylenoxideinheiten mit einem mindestens dreiarmig verzweigten Isocyanat-terminierten Präpolymer enthaltend Polyethylenoxid- und Polypropylenoxideinheiten in Gegenwart eines mehrwertigen Alkohols, ausgenommen Propylenglykol, wobei das Verhältnis reaktiver Isocyanatendgruppen zu reaktiven Aminendgruppen 1,0 bis 2,0, bevorzugt 1,0 bis 1,8, besonders bevorzugt 1,0 bis 1,6, ganz besonders bevorzugt 1,0 bis 1,5, am meisten bevorzugt 1,2 bis 1,3 beträgt und wobei das Gewichtsverhältnis von Polyethylenoxid- zu Polypropylenoxideinheiten sowohl im Amin-terminierten Präpolymer als auch im Isocyanat-terminierten Präpolymer 3 : 1 bis 7 : 1 beträgt.In particular, the hydrogel can be obtained by reacting an amine-terminated prepolymer containing polyethylene oxide and polypropylene oxide units with an at least three-armed branched isocyanate-terminated prepolymer containing polyethylene oxide and polypropylene oxide units in the presence of a polyhydric alcohol, with the exception of propylene glycol, the ratio of reactive isocyanate end groups to reactive amine end groups 1.0 to 2.0, preferably 1.0 to 1.8, particularly preferably 1.0 to 1.6, very particularly preferably 1.0 to 1.5, most preferably 1.2 to 1.3 and wherein the weight ratio of polyethylene oxide to polypropylene oxide units both in the amine-terminated prepolymer and in the isocyanate-terminated prepolymer is 3: 1 to 7: 1.
Ein typisches Amin-terminiertes Präpolymer ist beispielsweise ein Triblock-Polymer aus Propylenglykol-, Ethylenglykol- und wieder Propylenglykoleinheiten, wobei das Polymer endständig jeweils mit 2-Aminopropylgruppen aminfunktionalisiert ist. Es weist einen Gehalt reaktiver Aminendgruppen von 0,9554 mmol/g bei einem Molekulargewicht von durchschnittlich etwa 2000g/mol und einer Dispersität von 1,08, gemessen durch Gelpermeationschromatographie, auf und ein molares Verhältnis von Ethyleneinheiten zu Propyleneinheiten von 3:1 bis 7:1, bevorzugt 39:6. Ein derartiges Amin-terminiertes Präpolymer ist beispielsweise kommerziell erhältlich als Jeffamin® ED-2003, Huntsman; Everberg, Belgien.A typical amine-terminated prepolymer is, for example, a triblock polymer composed of propylene glycol, ethylene glycol and again propylene glycol units, the polymer being terminally amine-functionalized with 2-aminopropyl groups. It has a content of reactive amine end groups of 0.9554 mmol / g with an average molecular weight of about 2000 g / mol and a dispersity of 1.08, measured by gel permeation chromatography, and a molar ratio of ethylene units to propylene units of 3: 1 to 7: 1, preferably 39: 6. Such an amine-terminated prepolymer is commercially available, for example, as Jeffamin® ED-2003, Huntsman; Everberg, Belgium.
Ein typisches Isocyanat-terminiertes Präpolymer mit aliphatischen Diisocyanat-Gruppen ist beispielsweise ein dreiarmiges Copolymer aus Propylenglykol- und Polyethylenglykoleinheiten, welches endständig jeweils mit einem Molekül Isophorondiisocyanat umgesetzt wurde. Es weist einen Gehalt reaktiver Isocyanatendgruppen (NCO-Gruppen) von 3,0% bis 3,4%, bevorzugt 3,2% auf und ein molares Verhältnis von Ethylenoxideinheiten zu Propylenoxideinheiten von 3 : 1 bis 4:1. ein derartiges isocyanat-terminiertes Präpolymer mit aliphatischen Diisocyanat-Gruppen ist beispielsweise kommerziell erhältlich als Aquapol® PL-13000-3 (Carpenter; Richmond, USA).A typical isocyanate-terminated prepolymer with aliphatic diisocyanate groups is, for example, a three-armed copolymer of propylene glycol and polyethylene glycol units, each of which has been reacted at the end with a molecule of isophorone diisocyanate. It has a content of reactive isocyanate end groups (NCO groups) of 3.0% to 3.4%, preferably 3.2%, and a molar ratio of ethylene oxide units to propylene oxide units of 3: 1 to 4: 1. Such an isocyanate-terminated prepolymer with aliphatic diisocyanate groups is commercially available, for example, as Aquapol® PL-13000-3 (Carpenter; Richmond, USA).
Besonders bevorzugt ist ein Hydrogel, das erhältlich ist durch Umsetzung des besagten Amin-terminierten Präpolymers Jeffamin® ED-2003 mit dem besagten Isocyanat-terminierten Aquapol® PL-13000-3 in Gegenwart eines mehrwertigen Alkohols, ausgenommen Propylenglykol, wobei das Massenverhältnis von Aquapol zu Jeffamin zwischen 1,0 und 2,5, bevorzugt zwischen 1,1 und 1,7 liegt. Diese Gele zeigen eine ausreichende Gelfestigkeit für die Verwendung in Wundauflagen, während bei einem niedrigeren Verhältnis die erhaltenen Produkte viskose Flüssigkeiten darstellen und bei einem höheren Verhältnis die erhaltenen Produkte starre Gelkörper darstellen.Particularly preferred is a hydrogel which is obtainable by reacting said amine-terminated prepolymer Jeffamin® ED-2003 with said isocyanate-terminated Aquapol® PL-13000-3 in the presence of a polyhydric alcohol, with the exception of propylene glycol, the mass ratio of Aquapol to Jeffamine is between 1.0 and 2.5, preferably between 1.1 and 1.7. These gels show sufficient gel strength for use in wound dressings, while at a lower ratio the products obtained are viscous liquids and at a higher ratio the products obtained are rigid gel bodies.
Diese Hydrogele sind besonders gut geeignet Wasser einzulagern und dieses Wasser an eine Wunde abzugeben.These hydrogels are particularly suitable for storing water and delivering this water to a wound.
Bei den genannten Hydrogelen wird die feste Phase nicht allein durch ein Polymer gebildet, das aus der Reaktion zwischen einem Amin-terminierten Präpolymer und einem Isocyanat-terminierten Präpolymer entsteht. An der Reaktion ist ebenfalls ein mehrwertiger Alkohol, ausgenommen Propylenglykol, beteiligt, dessen freie Hydroxygruppen mit Isocyanatgruppen reagieren können. Die Komponente des mehrwertigen Alkohols trägt dabei zu einer zusätzlichen Vernetzung bei, die insbesondere bei mehrwertigen Alkoholen mit mehr als zwei Hydroxygruppen zu einer dreidimensionalen Vernetzung der Präpolymere führen. In der Reaktion zwischen einem mehrwertigen Alkohol und einer Isocyanatgruppe entsteht ein Carbamidsäureester, der auch als Urethan bezeichnet wird. Diese Reaktion kann durch Säuren oder Basen als Katalysator beschleunigt werden und unter Zufuhr von thermischer Energie rückgängig gemacht werden. Wird die Reaktionstemperatur konstant zwischen 5°C und 30°C, bevorzugt zwischen 5°C und 20°C, gehalten, kann diese Reaktion in einem ausreichenden Verhältnis erfolgen, so dass Hydrogele mit kovalent eingebundenen mehrwertigen Alkoholen erhalten werden, die vorteilhafte Eigenschaften aufweisen.In the hydrogels mentioned, the solid phase is not formed solely by a polymer that results from the reaction between an amine-terminated prepolymer and an isocyanate-terminated prepolymer. A polyhydric alcohol, with the exception of propylene glycol, is also involved in the reaction, the free hydroxyl groups of which can react with isocyanate groups. The polyhydric alcohol component contributes to an additional crosslinking which, in particular in the case of polyhydric alcohols with more than two hydroxyl groups, leads to a three-dimensional crosslinking of the prepolymers. The reaction between a polyhydric alcohol and an isocyanate group produces a carbamic acid ester, which is also known as urethane. This reaction can be accelerated by using acids or bases as a catalyst and can be reversed with the addition of thermal energy. If the reaction temperature is kept constant between 5 ° C. and 30 ° C., preferably between 5 ° C. and 20 ° C., this reaction can take place in a sufficient ratio so that hydrogels with covalently bound polyhydric alcohols are obtained which have advantageous properties.
Weiterhinenthalten erfindungsgemäße Hydrogele Glycerol. Dieser Alkohol ist hervorragend als Feuchtigkeitsspender geeignet und stellt somit für die die Wunde umgebende Haut eine pflegende Komponente dar. Hydrogele, die diesen Alkohol als Partner in den oben beschriebenen Reaktionen enthalten, weisen ein hohes Absorptionsvermögen für Wundexsudat und einen verringerten Feuchtigkeitsverlust auf. Sie weisen eine Adhäsionskraft auf, die einen atraumatischen Verbandwechsel erlaubt. Aufgrund ihrer geringen Zytotoxizität sind sie sehr gut verträglich für Wundgewebe. Außerdem sind derartige Gele in der Lage, für die Wundheilung notwendige Wachstumsfaktoren des Wundexsudats aufzukonzentrieren und so die Wundheilung zu beschleunigen. Dies gilt in besonderem Maße für Glycerol-haltige Hydrogele.Hydrogels according to the invention also contain glycerol. This alcohol is excellently suited as a moisturizer and thus represents a caring component for the skin surrounding the wound. Hydrogels which contain this alcohol as a partner in the reactions described above have a high absorption capacity for wound exudate and a reduced loss of moisture. They have an adhesive force that allows an atraumatic dressing change. Due to their low cytotoxicity, they are very well tolerated by wound tissue. In addition, such gels are able to concentrate the wound exudate growth factors necessary for wound healing and thus accelerate wound healing. This is particularly true for glycerol-containing hydrogels.
In einer bevorzugten Ausführungsform wird als mehrwertiger Alkohol Glycerol in einer Konzentration von 10-25 Gew.-% verwendet. Derartige Hydrogele weisen besonders vorteilhafte Eigenschaften hinsichtlich der Zellkompatibilität, des Flüssigkeitsverlusts und des Haftvermögens auf.In a preferred embodiment, glycerol is used as the polyhydric alcohol in a concentration of 10-25% by weight. Such hydrogels have particularly advantageous properties with regard to cell compatibility, fluid loss and adhesion.
In einer besonders bevorzugten Ausführungsform wird als mehrwertiger Alkohol Glycerol in einer Konzentration von 15-25 Gew.-% verwendet. Derartige Hydrogele weisen außerdem ein besonders hohes Absorptionsvermögen auf.In a particularly preferred embodiment, glycerol is used as the polyhydric alcohol in a concentration of 15-25% by weight. Such hydrogels also have a particularly high absorption capacity.
Ein erfindungsgemäßes Hydrogel enthält mindestens 40 Gew.-% und ganz besonders bevorzugt mindestens 50 Gew.-% Wasser, wobei das Hydrogel weiterhin bevorzugt höchstens 90 Gew.-% und weiterhin bevorzugt höchsten 80 Gew.-% Wasser umfasst. Somit kann ein Hydrogel zur Wundbehandlung bereitgestellt werden, das eine für eine natürliche Wundheilung ausreichende Menge Feuchtigkeit zur Verfügung stellt.A hydrogel according to the invention contains at least 40% by weight and very particularly preferably at least 50% by weight of water, the hydrogel further preferably comprising at most 90% by weight and furthermore preferably at most 80% by weight of water. It is thus possible to provide a hydrogel for wound treatment which provides an amount of moisture sufficient for natural wound healing.
Darüber hinaus kann vorgesehen sein, dass die wasserhaltige Hydrogelmatrix insbesondere mindestens ein Salz umfasst. Insbesondere ist hierbei vorgesehen, dass die Hydrogelmatrix ein anorganisches Salz umfasst. Besonders geeignet sind in diesem Zusammenhang Chloride, lodide, Sulfate, Hydrogensulfate, Karbonate, Hydrogenkarbonate, Phosphate, Dihydrogenphosphate oder Hydrogenphosphate der Alkali- und Erdalkalimetalle. Bevorzugt umfasst die Hydrogelmatrix Natriumchlorid, Kaliumchlorid, Magnesiumchlorid, Kalziumchlorid oder Mischungen hiervon. Besonders bevorzugt ist Natriumchlorid. Diese Salze simulieren in besonders guter Weise das Elektrolyt-Gemisch in einem von einer Wunde abgegebenen Wundserum. Damit stellt eine diese Salze umfassende Hydrogelmatrix einer Wunde ein besonders wundheilungsförderndes Klima zur Verfügung.In addition, it can be provided that the water-containing hydrogel matrix in particular comprises at least one salt. In particular, it is provided here that the hydrogel matrix comprises an inorganic salt. Chlorides, iodides, sulfates, hydrogen sulfates, carbonates, hydrogen carbonates, phosphates, dihydrogen phosphates or hydrogen phosphates of the alkali and alkaline earth metals are particularly suitable in this connection. The hydrogel matrix preferably comprises sodium chloride, potassium chloride, magnesium chloride, calcium chloride or mixtures thereof. Sodium chloride is particularly preferred. These salts simulate the electrolyte mixture in a wound serum released by a wound in a particularly good way. A hydrogel matrix comprising these salts thus provides a wound with a climate that is particularly conducive to wound healing.
Hierbei kann vorgesehen sein, dass die Hydrogelmatrix 0 bis 5 Gew.-% mindestens ein Salz umfasst. Insbesondere umfasst die Hydrogelmatrix 0,1 bis 3 Gew.-% eines Salzes und ganz besonders bevorzugt 0,5 bis 1,5 Gew.-% eines Salzes.It can be provided here that the hydrogel matrix comprises 0 to 5% by weight of at least one salt. In particular, the hydrogel matrix comprises 0.1 to 3% by weight of a salt and very particularly preferably 0.5 to 1.5% by weight of a salt.
Erfindungsgemäße Hydrogele sind für die Behandlung von Wunden geeignet. Sie können als halbfeste, plastisch verformbare Massen mittels geeigneter Applikationsvorrichtungen auf eine Wundoberfläche verteilt werden. Geeignete Applikationsvorrichtungen sind dabei beispielsweisen Tuben oder angepasste Spritzen.Hydrogels according to the invention are suitable for the treatment of wounds. They can be distributed as semi-solid, plastically deformable masses on a wound surface by means of suitable application devices. Suitable application devices are, for example, tubes or adapted syringes.
Erfindungsgemäße Hydrogele sind bevorzugt Bestandteil einer Wundauflage. Unter einer Wundauflage wird im Rahmen der vorliegenden Erfindung ein Produkt verstanden, das auf eine Wunde aufgebracht wird in gebrauchsfertiger Form zur Verfügung gestellt wird. Geeignete Wundauflagen weisen dabei wenigstens eine Schicht aus einem Trägermaterial und eine Schicht umfassend ein erfindungsgemäßes Hydrogel auf.Hydrogels according to the invention are preferably part of a wound dressing. In the context of the present invention, a wound pad is understood to mean a product which is applied to a wound and is made available in ready-to-use form. Suitable wound dressings have at least one layer made of a carrier material and one layer comprising a hydrogel according to the invention.
Als Trägerschicht können insbesondere Polymerfilme oder Polymerschäume eingesetzt werden, vorzugsweise Filme oder Schäume, die aus Polyurethan, Polyetherurethan, Polyesterurethan, Polyether-Polyamid-Copolymeren, Polyacrylat oder Polymethacrylat gefertigt werden. Insbesondere ist als Trägerschicht ein wasserundurchlässiger und wasserdampfdurchlässiger Polyurethanfilm oder ein wasserundurchlässiger und wasserdampfdurchlässiger Polyurethanschaum geeignet. Insbesondere ist als Polymerfilm ein Polyurethanfilm, Polyesterurethanfilm oder Polyetherurethanfilm bevorzugt. Ganz besonders sind aber auch solche Polymerfilme bevorzugt, die eine Dicke von 15 µm bis 50 µm, insbesondere 20 µm bis 40 µm und ganz besonders bevorzugt von 25 µm bis 30 µm aufweisen. Die Wasserdampfdurchlässigkeit des Polymerfilms der Wundauflage weist vorzugsweise mindestens 750 g/m2/24h, insbesondere mindestens 1000 g/m2/24h und ganz besonders bevorzugt mindestens 2000 g/m2/24h auf (gemessen nach DIN EN 13726). In besonders bevorzugten Ausführungsformen weisen diese Filme einen feuchtigkeitsdichten, klebenden Randabschnitt auf. Dieser Randabschnitt gewährleistet, dass das Wundsystem an seinem bestimmungsgemäßen Ort appliziert und fixiert werden kann. Darüber hinaus ist sichergestellt, dass keine Flüssigkeit zwischen der Folie und der die zu behandelnden Fläche umgebende Haut austreten kann. Als besonders bevorzugt sind solche Klebstoffe zu betrachten, die in einem dünnen Auftrag von 20 g/m2 bis 35 g/m2 zusammen mit dem Film eine Wasserdampfdurchlässigkeit von mindestens 800 g/m2/24h und vorzugsweise von mindestens 1000 g/m2/24h (gemessen nach DIN EN 13726) aufweisen.In particular, polymer films or polymer foams can be used as the carrier layer, preferably films or foams made from polyurethane, polyether urethane, polyester urethane, polyether-polyamide copolymers, polyacrylate or polymethacrylate. In particular, a water-impermeable and water-vapor-permeable polyurethane film or a water-impermeable and water-vapor-permeable polyurethane foam is suitable as the carrier layer. In particular, a polyurethane film, polyester urethane film or polyether urethane film is preferred as the polymer film. However, polymer films which have a thickness of 15 μm to 50 μm, in particular 20 μm to 40 μm and very particularly preferably 25 μm to 30 μm are also very particularly preferred. The water vapor permeability of the polymer film of the wound dressing is preferably at least 750 g / m 2 / 24h, in particular at least 1000 g / m 2 / 24h and very particularly preferably at least 2000 g / m 2 / 24h (measured according to DIN EN 13726). In particularly preferred embodiments, these films have a moisture-proof, adhesive edge section. This edge section ensures that the wound system can be applied and fixed at its intended location. In addition, it is ensured that no liquid can escape between the film and the skin surrounding the area to be treated. Particularly preferred are those adhesives which, in a thin application of 20 g / m 2 to 35 g / m 2 together with the film, have a water vapor permeability of at least 800 g / m 2 / 24h and preferably of at least 1000 g / m 2 / 24h (measured according to DIN EN 13726).
In einer bevorzugten Ausführungsform umfasst die absorbierende Schicht einen hydrophilen Polyurethanschaum sowie das Hydrogel. Beispielsweise kann die Oberfläche eines hydrophilen Polyurethanschaums mit dem Hydrogel imprägniert bzw. beschichtet oder von diesem ganz oder teilweise durchsetzt sein.In a preferred embodiment, the absorbent layer comprises a hydrophilic polyurethane foam and the hydrogel. For example, the surface of a hydrophilic polyurethane foam can be impregnated or coated with the hydrogel or completely or partially penetrated by this.
In einer alternativen Ausführungsform kann die Hydrogelzusammensetzung auch benachbart oder räumlich getrennt von der absorbierenden Schicht vorliegen. Beispielsweise kann die Hydrogelzusammensetzung, beispielsweise umfassend ein Polyurethan-Polyharnstoff-Copolymer auf eine Oberfläche einer Schicht aus einem Polyurethanschaum beschichtet werden, so dass eine die Hydrogelzusammensetzung umfassende Hydrogelschicht in direktem Kontakt auf einer Schicht aus Polyurethanschaum aufliegt. Alternativ können die Hydrogelschicht und die absorbierende Schicht auch durch eine Abstandsschicht voneinander getrennt sein. Beispielsweise kann die Abstandschicht eine Hydrogelmatrix, ein Polymerfilm, eine Hydrokolloidmatrix, ein Polymernetz, ein Textilgewebe, ein Adhäsiv und/oder ein Polymernetz umfassen.In an alternative embodiment, the hydrogel composition can also be present adjacent to or spatially separated from the absorbent layer. For example, the hydrogel composition, for example comprising a polyurethane-polyurea copolymer, can be coated on a surface of a layer of a polyurethane foam so that a hydrogel layer comprising the hydrogel composition rests in direct contact on a layer of polyurethane foam. Alternatively, the hydrogel layer and the absorbent layer can also be separated from one another by a spacer layer. For example, the spacer layer can comprise a hydrogel matrix, a polymer film, a hydrocolloid matrix, a polymer network, a textile fabric, an adhesive and / or a polymer network.
Ferner kann die mehrschichtige Wundauflage auch weitere Schichten neben der absorbierenden Schicht und der Trägerschicht umfassen, wie beispielsweise eine Wundkontaktschicht, eine oder mehrere Barriereschichten und/oder eine oder mehrere Verteilerschichten.Furthermore, the multilayer wound dressing can also comprise further layers in addition to the absorbent layer and the carrier layer, such as, for example, a wound contact layer, one or more barrier layers and / or one or more distribution layers.
Bevorzugte Wundauflagen umfassen eine Trägerschicht, eine Hydrogelschicht gemäß der vorliegenden Erfindung und fakultativ eine zwischen der Hydrogelschicht und der Trägerschicht angeordnete absorbierende Schicht. Die absorbierende Schicht kann bevorzugt ein Fasermaterial, besonders bevorzugt einen hydrophilen Polyurethanschaum umfassen. Die Hydrogelschicht kann kontinuierlich oder diskontinuierlich sein. Sie kann beispielsweise vollflächig auf die Trägerschicht aufgebracht sein oder Kanäle, Löcher oder anders geformte Öffnungen aufweisen. Bei einer diskontinuierlichen Hydrogelschicht kann eine Vielzahl diskreter Hydrogelelemente auf der Trägerschicht und/oder auf der absorbierenden Schicht aufgebracht sein, die die Form von Kreisen, Quadraten oder anderen regelmäßigen oder unregelmäßigen Vielecken aufweisen können.Preferred wound dressings comprise a carrier layer, a hydrogel layer according to the present invention and, optionally, an absorbent layer arranged between the hydrogel layer and the carrier layer. The absorbent layer can preferably comprise a fiber material, particularly preferably a hydrophilic polyurethane foam. The hydrogel layer can be continuous or discontinuous. It can, for example, be applied over the entire surface of the carrier layer or have channels, holes or other shaped openings. In the case of a discontinuous hydrogel layer, a multiplicity of discrete hydrogel elements can be applied to the carrier layer and / or to the absorbent layer, which elements can have the shape of circles, squares or other regular or irregular polygons.
Mögliche Anordnungen der verschiedenen Schichten in erfindungsgemäßen mehrschichtigen Wundauflagen sind beispielsweise in der
Die Wundauflagen weisen ferner einen hohen Komfort für den Patienten auf, indem sie einfach anzuwenden, hautfreundlich, weich, dünn, hautanpassend und analgetisch (über einen Hydrogel-Kühlungseffekt) sind und können somit auch über einen langen Zeitraum angewendet werden, üblicherweise 3 bis 5 Tagen, bevor ein Wechsel der Wundauflage erfolgt. Das Trägermaterial kann vollflächig oder partiell, kontinuierlich oder diskontinuierlich mit einem Klebstoff beschichtet sein.The wound dressings also have a high level of comfort for the patient in that they are easy to use, skin-friendly, soft, thin, skin-conforming and analgesic (via a hydrogel cooling effect) and can therefore also be used over a long period of time, usually 3 to 5 days before changing the dressing. The carrier material can be coated with an adhesive over the entire surface or partially, continuously or discontinuously.
In einer erfindungsgemäßen Wundauflage kann ein erfindungsgemäßes Hydrogel direkt auf einer Trägerschicht aufgetragen sein. Es kann auch mit Hilfe eines Klebstoffes zum besseren Zusammenhalt aufgebracht sein. Zwischen der Trägerschicht und der Hydrogelschicht können weitere Schichten angeordnet sein. Es hat sich als vorteilhaft herausgestellt, wenn eine Wundauflage als zusätzliche Schicht eine Schicht aufweist, die in der Lage ist, Flüssigkeit aufzunehmen, zu speichern und/oder innerhalb der Schicht zu verteilen oder zu weiteren Schichten zu transferieren. Geeignete Schichten, die in der Lage sind Flüssigkeiten aufzunehmen, sind Vliesmaterialien aus natürlichen oder synthetischen Fasern oder Mischungen davon, offenporige Schaummaterialien oder Materialien, die eine hydrophobe Matrix enthalten, in der Flüssigkeit aufnehmende Partikel enthalten sind. Bevorzugt ist ein offenporiges Schaummaterial aus Polyurethan. Ein erfindungsgemäßes Wundversorgungsprodukt umfasst bevorzugt einen hydrophilen Polyurethanschaum. Die Verwendung eines hydrophilen Polyurethanschaums ist für eine schnelle Wundheilung vorteilhaft, weil solche Schäume eine hohe Absorptionskapazität aufweisen und daher vorzugsweise in der Reinigungsphase der Wundheilung bei starker Exsudation eingesetzt werden. Ein weiterer Vorteil von Polyurethanschäumen besteht darin, dass nur geringe Scherkräfte auf eine zu behandelnde Wunde ausgeübt werden und die Wunde somit gut abgepolstert wird.In a wound dressing according to the invention, a hydrogel according to the invention can be applied directly to a carrier layer. It can also be used with the help of an adhesive better cohesion. Further layers can be arranged between the carrier layer and the hydrogel layer. It has been found to be advantageous if a wound dressing has a layer as an additional layer which is capable of absorbing, storing and / or distributing liquid within the layer or transferring it to further layers. Suitable layers which are able to absorb liquids are nonwoven materials made of natural or synthetic fibers or mixtures thereof, open-pore foam materials or materials which contain a hydrophobic matrix in which particles which absorb liquids are contained. An open-cell foam material made of polyurethane is preferred. A wound care product according to the invention preferably comprises a hydrophilic polyurethane foam. The use of a hydrophilic polyurethane foam is advantageous for rapid wound healing because such foams have a high absorption capacity and are therefore preferably used in the cleaning phase of wound healing in the case of heavy exudation. Another advantage of polyurethane foams is that only low shear forces are exerted on a wound to be treated and the wound is thus well padded.
Im Zusammenhang mit der vorliegenden Erfindung wird unter einem hydrophilen Polyurethanschaum ein Polyurethanschaum verstanden, der eine Flüssigkeit in seine Polyurethanmatrix und in seine Poren aufnehmen und speichern, somit absorbieren kann, und zumindest einen Teil der aufgenommenen Flüssigkeit wieder abgeben kann. Als hydrophile Polymerschäume sind hierbei insbesondere offenporige, hydrophile Polyurethanschäume geeignet. Demgemäß umfasst eine besonders bevorzugte Wundauflage eine Schicht, die einen offenporigen, hydrophilen Polyurethanschaum umfasst. Erfindungsgemäß sollen vorzugsweise Polyurethanschäume eingesetzt werden, die eine hohe Absorptionskapazität für Flüssigkeiten von mehr als 2,5 g, bevorzugt mehr als 10 g, noch mehr bevorzugt mehr als 16 g isotonischer Salzlösung pro Gramm Schaumpolymer aufweisen. Die Absorptionsfähigkeit wird nach DIN EN 13726-1:2002 (3 min Messung) bestimmt. Ein derartiger Schaum kann Keime und Zelltrümmer absorbieren und sicher einschließen, dabei aber trotzdem weich, geschmeidig und mit einer guten Polsterwirkung auf der Wunde aufliegen.In connection with the present invention, a hydrophilic polyurethane foam is understood to mean a polyurethane foam which can take up and store a liquid in its polyurethane matrix and in its pores, thus absorb it, and release at least part of the taken up liquid again. Open-pored, hydrophilic polyurethane foams are particularly suitable as hydrophilic polymer foams. Accordingly, a particularly preferred wound dressing comprises a layer which comprises an open-pored, hydrophilic polyurethane foam. According to the invention, polyurethane foams should preferably be used which have a high absorption capacity for liquids of more than 2.5 g, preferably more than 10 g, even more preferably more than 16 g of isotonic salt solution per gram of foam polymer. The absorption capacity is determined according to DIN EN 13726-1: 2002 (3 min measurement). Such a foam can absorb germs and cell debris and safely enclose it, but still lie soft, supple and with a good cushioning effect on the wound.
Vorzugsweise weist der hydrophile Polyurethanschaum eine durchschnittliche Porengröße von weniger als 1000 µm, insbesondere 100 bis 1000 µm, bevorzugt 100 bis 500 µm und ganz besonders bevorzugt 100 bis 300 µm auf. Die bevorzugte Methode zur Bestimmung der Porengröße ist die Messung des Durchmessers einer Vielzahl von Poren auf einer Schnittebene, die parallel zur Wundkontaktseite der Schaumschicht bzw. des Wundversorgungsprodukts orientiert ist. Die Messung der Porengröße kann durch Betrachten der Poren in einem Licht- oder Elektronenmikroskop und Vergleich des Porendurchmessers mit einem geeigneten Maßstab erfolgen. Der Schaum kann eine homogene Porengröße oder einen Gradienten der Porengröße über die Dicke der Schaumschicht aufweisen. Bei Verwendung eines Schaums, welcher einen Gradienten der Porengröße ausweist, wird durch eine von der Wundkontaktschicht ausgehende Verringerung der Porengröße von größeren Poren an der Wundkontaktseite (mittlere Porengröße z.B. 200-300 µm) bis hin zu kleineren Poren an der im Gebrauch von der Wunde abgewandten Seite des Schaums (mittlere Porengröße z.B. 100-200 µm) eine effiziente Ableitung von Wundexsudat gewährleistet. Eine effiziente Ableitung von Wundexsudat ergibt sich, weil ein Kapillareffekt für eine besonders gute Absorption von Flüssigkeiten erzeugt werden kann. Gleichzeitig kann der Schaum eine ausreichende Menge an Feuchtigkeit für eine Wunde bereitstellen. Ein Schaum mit einem Gradienten der Porengröße über die Dicke des Schaums und einer Porengröße von weniger als 1000 µm kommt beispielsweise bei dem Produkt Permafoam der Paul Hartmann AG zum Einsatz. Darüber hinaus ist es besonders vorteilhaft, wenn die Wundauflage außerdem eine wasserdampf-durchlässige Polyurethan-Deckschicht aufweist. Weiterhin ist es vorteilhaft, wenn die wasserdampfdurchlässige Polyurethan-Deckschicht eine Wasserdampfdurchlässigkeit ("upright", gemessen nach DIN EN 13726-2 bei einer Temperatur von 37°C) von mehr als 600 g/m2 in 24 h aufweist.The hydrophilic polyurethane foam preferably has an average pore size of less than 1000 μm, in particular 100 to 1000 μm, preferably 100 to 500 μm and very particularly preferably 100 to 300 μm. The preferred method of determining pore size is to measure the diameter of a plurality of pores on one Section plane which is oriented parallel to the wound contact side of the foam layer or the wound care product. The measurement of the pore size can be done by looking at the pores in a light or electron microscope and comparing the pore diameter with a suitable scale. The foam can have a homogeneous pore size or a gradient of the pore size over the thickness of the foam layer. When using a foam which has a gradient in the pore size, a reduction in the pore size starting from the wound contact layer from larger pores on the wound contact side (mean pore size e.g. 200-300 µm) to smaller pores on the one facing away from the wound during use Side of the foam (mean pore size, for example 100-200 µm) ensures efficient drainage of wound exudate. An efficient drainage of wound exudate results because a capillary effect can be generated for particularly good absorption of liquids. At the same time, the foam can provide a sufficient amount of moisture for a wound. A foam with a pore size gradient across the thickness of the foam and a pore size of less than 1000 µm is used, for example, in the product Permafoam from Paul Hartmann AG. In addition, it is particularly advantageous if the wound dressing also has a water-vapor-permeable polyurethane cover layer. It is also advantageous if the water vapor permeable polyurethane top layer has a water vapor permeability ("upright", measured according to DIN EN 13726-2 at a temperature of 37 ° C.) of more than 600 g / m 2 in 24 h.
Denkbar und vorteilhaft ist es darüber hinaus, wenn die Wundauflage wundseitig ein netzförmiges Hydrogel aufweist. Weiterhin ist es vorteilhaft, wenn die Wundauflage wundabseitig eine Polyurethan-Deckschicht umfasst.It is also conceivable and advantageous if the wound dressing has a reticulated hydrogel on the wound side. It is also advantageous if the wound dressing comprises a polyurethane cover layer away from the wound.
Des Weiteren ist es von Vorteil, wenn der Schaum eine Dichte von 70 bis 110 kg/m3 aufweist. Gemäß einer weiteren Ausführung der Erfindung kann ein hydrophober PU-Schaum mit einer Dichte von 10 bis 50 kg/m3 verwendet werden. Derartige Schäume werden insbesondere bei Wundauflagen, welche für eine Unterdruck-Therapie von Wunden vorgesehen sind, eingesetzt. In einer weiteren Ausführung der Erfindung wäre es weiterhin denkbar und vorteilhaft, Silikonschäume mit einer Dichte von bis zu 300 kg/m3 einzusetzen.It is also advantageous if the foam has a density of 70 to 110 kg / m3. According to a further embodiment of the invention, a hydrophobic PU foam with a density of 10 to 50 kg / m 3 can be used. Such foams are used in particular in wound dressings which are intended for negative pressure therapy of wounds. In a further embodiment of the invention, it would also be conceivable and advantageous to use silicone foams with a density of up to 300 kg / m 3.
Polyurethanschaumstoffe sind üblicherweise erhältlich durch Umsetzung einer härtbaren Mischung, umfassend die Komponenten Polyisocyanat und gegenüber Isocyanat reaktiver Verbindungen, insbesondere Polyol, sowie Katalysatoren, Treibmitteln und gegebenenfalls Zusatzstoffen. Als Isocyanate können allgemein bekannte aliphatische, cycloaliphatische und/oder insbesondere aromatische Polyisocyanate eingesetzt werden. Zur Herstellung der Polyurethane eignen sich beispielsweise Diphenylmethandiisocyanat, hier insbesondere 4,4'-Diphenylmethandiisocyanat, Mischungen aus monomeren Diphenylmethandiisocyanaten und höherkernigen Homologen des Diphenylmethandiisocyanats, Tetramethylendiisocyanat, Hexamethylendiisocyanat, Toluylendiisocyanat oder Mischungen daraus. Als gegenüber Isocyanaten reaktive Verbindungen werden üblicherweise Polyole wie Polyetherole und/oder Polyesterole verwendet.Polyurethane foams are usually obtainable by reacting a curable mixture, comprising the components polyisocyanate and compounds reactive toward isocyanate, in particular polyol, as well as catalysts, blowing agents and optionally Additives. Generally known aliphatic, cycloaliphatic and / or, in particular, aromatic polyisocyanates can be used as isocyanates. For example, diphenylmethane diisocyanate, in particular 4,4'-diphenylmethane diisocyanate, mixtures of monomeric diphenylmethane diisocyanates and higher nuclear homologues of diphenylmethane diisocyanate, tetramethylene diisocyanate, hexamethylene diisocyanate, tolylene diisocyanate or mixtures thereof are suitable for producing the polyurethanes. Isocyanate-reactive compounds are usually polyols such as polyetherols and / or polyesterols.
Als besonders vorteilhafte Ausführungen haben sich weiterhin Schaumwundauflagen gezeigt, die einen Polyurethanschaum umfassen, dessen Schichtdicke 0,1 cm bis 1,8 cm, bevorzugt von 0,3 cm bis 1,5 cm und ganz besonders bevorzugt von 0,5 cm bis 1,0 cm, aufweist. Die Schichtdicke kann an jeder Stelle der Wundkontaktschicht gleich sein oder in verschiedenen Bereichen der Wundkontaktschicht verschiedene Werte annehmen. Insbesondere ist auch vorgesehen, dass die absorbierende Schicht oder der Polyurethanschaum abgeflachte Ränder aufweist.Foam wound dressings which comprise a polyurethane foam whose layer thickness is 0.1 cm to 1.8 cm, preferably from 0.3 cm to 1.5 cm and very particularly preferably from 0.5 cm to 1, have also been shown to be particularly advantageous designs. 0 cm. The layer thickness can be the same at every point on the wound contact layer or assume different values in different areas of the wound contact layer. In particular, it is also provided that the absorbent layer or the polyurethane foam has flattened edges.
Bevorzugt weist das Wundversorgungsprodukt eine im Wesentlichen quadratische Grundform auf. Besonders bevorzugt ist dabei ein Größenbereich von 8 cm x 8 cm bis zu 20 cm x 20 cm. Die Dicke des Wundversorgungsprodukts beträgt bevorzugt weniger als 2 cm, wobei die Schaumschicht bevorzugt eine Dicke zwischen 0,1 cm und 1,8 cm aufweist.The wound care product preferably has an essentially square basic shape. A size range of 8 cm x 8 cm up to 20 cm x 20 cm is particularly preferred. The thickness of the wound care product is preferably less than 2 cm, the foam layer preferably having a thickness between 0.1 cm and 1.8 cm.
Als Wundkontaktschicht kann gemäß der vorliegenden Erfindung ein zusätzliches Material Verwendung finden. Hierbei steht eine Wundkontaktschicht bei Verwendung der erfindungsgemäßen Wundauflage in direktem Kontakt mit der Wunde. Die Wundkontaktschicht kann einzig und allein dazu dienen, den Schaum von der zu behandelnden Wunde zu beabstanden. Die zusätzliche Schicht hat den Vorteil, bei einem Verbandswechsel eine besonders gewebeschonende Ablösung des Wundversorgungsprodukts zu gewährleisten. Die Wundkontaktschicht kann weitere Funktionen in Bezug auf die zu behandelnde Wunde ausüben. Beispielsweise kann die Wundkontaktschicht die Wunde mit Feuchtigkeit versorgen, wundrandpflegende Eigenschaften aufweisen, Hautirritationen vermindern oder antiadherent wirken.According to the present invention, an additional material can be used as the wound contact layer. A wound contact layer is in direct contact with the wound when the wound dressing according to the invention is used. The only purpose of the wound contact layer is to space the foam away from the wound to be treated. The additional layer has the advantage of ensuring that the wound care product is removed in a manner that is particularly gentle on the tissue when the dressing is changed. The wound contact layer can perform further functions in relation to the wound to be treated. For example, the wound contact layer can supply the wound with moisture, have wound edge care properties, reduce skin irritation or have an antiadherent effect.
Eine erfindungsgemäße Wundauflage kann eine Wundkontaktschicht aufweisen, wobei die Wundkontaktschicht ein Hydrogel, einen Polymerfilm, eine Hydrokolloidmatrix, ein Polymernetz, ein Nonwoven und/oder ein Adhäsiv umfasst. Der Begriff Hydrogel bzw. Gel bezeichnet dabei im Rahmen der Erfindung ein feindisperses System aus mindestens einer festen und einer flüssigen Phase. Diese feste Phase bildet dabei ein schwammartiges, dreidimensionales Netzwerk, dessen Poren durch eine Flüssigkeit (Lyogel) bzw. auch ein Gas (Xerogel) ausgefüllt sind. Beide Phasen durchdringen sich dabei vollständig.A wound dressing according to the invention can have a wound contact layer, the wound contact layer comprising a hydrogel, a polymer film, a hydrocolloid matrix, a polymer mesh, a nonwoven and / or an adhesive. The term hydrogel or gel In the context of the invention, denotes a finely dispersed system composed of at least one solid and one liquid phase. This solid phase forms a spongy, three-dimensional network, the pores of which are filled by a liquid (lyogel) or a gas (xerogel). Both phases penetrate each other completely.
Damit soll im Zusammenhang mit der vorliegenden Erfindung unter einem hydrophilen Polymerschaum mit einem Wasseranteil von mindestens 10 Gew.-% oder einem hydrophilen Polyurethanschaum mit einem Wasseranteil von mindestens 10 Gew.-% ein solcher Polymerschaum oder Polyurethanschaum verstanden sein, der mindestens 10 Gew.-% Wasser umfasst, wobei das Wasser von dem Polymerschaum oder dem Polyurethanschaum freigesetzt werden kann. Im Unterschied hierzu ist nicht der Anteil an Wasser zu verstehen, der eventuell zur Bildung beispielsweise bei der Polymerisation der Ausgangsprodukte des Polymerschaums oder des Polyurethanschaums verwendet wird. Dieses Wasser wird kovalent gebunden und steht nicht der Wundbehandlung zur Verfügung. Darüber hinaus soll auch nicht ein Wasseranteil verstanden sein, der produktionsbedingt bei der Herstellung des Schaums verwendet wird. Dieser Wasseranteil wird nach oder während der Bildung des Polymerschaums dem Schaum meist durch Trocknen, beispielsweise durch Trocknen in einem Ofen, entzogen und steht somit auch nicht der Wundbehandlung zur Verfügung. Damit weist eine erfindungsgemäße Wundauflage einen Polymerschaum oder einen Polyurethanschaum auf, der einen Wasseranteil umfasst, der deutlich über einem eventuell durch die Herstellung nach Trocknung bedingten Restgehalt an Wasser übersteigt.In connection with the present invention, a hydrophilic polymer foam with a water content of at least 10 wt.% Or a hydrophilic polyurethane foam with a water content of at least 10 wt. Comprises% water, wherein the water can be released from the polymer foam or the polyurethane foam. In contrast to this, the proportion of water that may be used for formation, for example during the polymerization of the starting products of the polymer foam or of the polyurethane foam, is not to be understood. This water is covalently bound and is not available for wound treatment. In addition, a proportion of water that is used for production reasons in the manufacture of the foam is also not to be understood. After or during the formation of the polymer foam, this water content is usually removed from the foam by drying, for example by drying in an oven, and is therefore also not available for wound treatment. A wound dressing according to the invention thus has a polymer foam or a polyurethane foam which comprises a water content which clearly exceeds a residual water content possibly caused by the production after drying.
Weiterhin bevorzugt umfasst eine erfindungsgemäße Wundauflage einen hydrophilen Polyurethanschaum, der einen Retentionswert R von mindestens 20 % aufweist. Hierbei ist weiterhin bevorzugt vorgesehen, dass der hydrophile Polyurethanschaum einen Retentionswert R von mindestens 30 %, insbesondere von mindestens 40 %, insbesondere mindestens 40 % und ganz besonders bevorzugt von mindestens 50 % aufweist. Unabhängig hiervon kann weiterhin bevorzugt vorgesehen sein, dass die Wundauflage einen hydrophilen Polyurethanschaum aufweist, der einen Retentionswert R von höchstens 90 %, insbesondere von höchstens 80 % und ganz besonders von höchstens 70 % aufweist. Der Retentionswert R wird dabei gemäß einer hierin beschriebenen Methode bestimmt.Furthermore, a wound dressing according to the invention preferably comprises a hydrophilic polyurethane foam which has a retention value R of at least 20%. It is furthermore preferably provided here that the hydrophilic polyurethane foam has a retention value R of at least 30%, in particular of at least 40%, in particular at least 40% and very particularly preferably of at least 50%. Independently of this, it can furthermore preferably be provided that the wound dressing has a hydrophilic polyurethane foam which has a retention value R of at most 90%, in particular of at most 80% and very particularly of at most 70%. The retention value R is determined according to a method described herein.
Ganz besonders bevorzugt umfasst eine erfindungsgemäße Wundauflage einen hydrophilen Polyurethanschaum, der einen Wasseranteil von mindestens 10 Gew.-% umfasst, wobei der Wasseranteil dem Retentionswert R des Polyurethanschaums entspricht.A wound pad according to the invention very particularly preferably comprises a hydrophilic polyurethane foam which has a water content of at least 10% by weight, the water content corresponding to the retention value R of the polyurethane foam.
Das Hydrogel kann auf unterschiedliche Arten zur Wundbehandlung eingesetzt werden. Das Gel kann zuerst auf die Wunde aufgetragen und dann mit einer Wundauflage abgedeckt werden. Eine andere Möglichkeit, das Gel zur Wundbehandlung einzusetzen, besteht darin, eine Wundauflage zu verwenden, die das Hydrogel in einer Wundkontaktschicht bereithält. Auf diese Weise werden die den pH-Wert im sauren Bereich stabilisierenden Eigenschaften des Gels in der Wunde bereitgestellt.The hydrogel can be used in different ways to treat wounds. The gel can be applied to the wound first and then covered with a wound pad. Another possibility of using the gel for wound treatment is to use a wound dressing that holds the hydrogel in a wound contact layer. In this way, the pH stabilizing properties of the gel in the acidic range are provided in the wound.
Als besonders vorteilhafte Ausführungen haben sich weiterhin Wundauflagen gezeigt, die eine Hydrogelmatrix umfassen, deren Schichtdicke 0,1 bis 5,0 mm aufweist. Insbesondere weist damit eine erfindungsgemäße Wundauflage eine Wundkontaktschicht mit einer Schichtdicke von 0,1 bis 5,0 mm, insbesondere von 0,5 bis 5,0 mm und ganz besonders bevorzugt von 0,5 bis 3,0 mm auf. Wundauflagen mit solchen Schichtdicken zeigen einerseits keine Wundverklebung und andererseits die Fähigkeit ein von einer Wunde abgegebenes Wundexsudat aufzunehmen und an die absorbierende Schicht weiterzuleiten. Diese Schichtdicken können an jeder Stelle der Wundkontaktschicht gleich sein oder in verschiedenen Bereichen der Wundkontaktschicht verschiedene Werte annehmen.Wound dressings that comprise a hydrogel matrix with a layer thickness of 0.1 to 5.0 mm have also been shown to be particularly advantageous embodiments. In particular, a wound dressing according to the invention thus has a wound contact layer with a layer thickness of 0.1 to 5.0 mm, in particular 0.5 to 5.0 mm and very particularly preferably 0.5 to 3.0 mm. Wound dressings with such layer thicknesses show, on the one hand, no wound adhesion and, on the other hand, the ability to absorb wound exudate released by a wound and to pass it on to the absorbent layer. These layer thicknesses can be the same at every point on the wound contact layer or assume different values in different areas of the wound contact layer.
Weiterhin bevorzugt kann die Hydrogelmatrix Kanäle umfassen, insbesondere konische Kanäle, zum Durchtritt von Flüssigkeiten von der ersten zur zweiten Seite. Hierdurch kann insbesondere ein verbesserter Durchtritt für Wundexsudat bereitgestellt werden. Hierbei ist besonders bevorzugt vorgesehen, dass die Kanäle einen elliptischen oder einen kreisförmigen Querschnitt aufweisen, d.h. dass die Kanäle eine kreisförmige oder elliptische Öffnung sowohl an der der ersten als auch an der zweiten Seite der Hydrogelmatrix aufweisen, wobei die kreisförmige oder elliptische Öffnung auf der ersten und der zweiten Seite verschieden groß sind. Es kann jedoch auch vorgesehen sein, dass die Kanäle einen dreieckigen, rechteckigen, quadratischen, fünfeckigen, sechseckigen oder einen anderen vieleckigen Querschnitt aufweisen. Dabei ist ganz besonders bevorzugt vorgesehen, dass die erste Seite Öffnungen aufweist, die im Vergleich zu der auf der zweiten Seite befindliche Öffnung größer ist.Furthermore, the hydrogel matrix can preferably comprise channels, in particular conical channels, for the passage of liquids from the first to the second side. In this way, in particular, an improved passage for wound exudate can be provided. It is particularly preferred that the channels have an elliptical or circular cross-section, ie that the channels have a circular or elliptical opening on both the first and the second side of the hydrogel matrix, the circular or elliptical opening on the first and the second side are of different sizes. However, it can also be provided that the channels have a triangular, rectangular, square, pentagonal, hexagonal or other polygonal cross section. It is very particularly preferably provided that the first side has openings which are larger in comparison to the opening located on the second side.
Gemäß einer Weiterbildung der Erfindung kann auch vorgesehen sein, dass die Wundkontaktschicht oder die Hydrogelmatrix Öffnungen aufweist, die einen Durchmesser von 0,5 bis 5 mm aufweisen. Insbesondere weist die Wundkontaktschicht oder die Hydrogelmatrix Öffnungen auf, die einen Durchmesser von 1 bis 3 mm aufweisen. Ganz besonders bevorzugt weist die Wundkontaktschicht oder die Hydrogelmatrix auf der wundzugewandten ersten Seite Öffnungen auf, die einen Durchmesser von 1 bis 3 mm aufweisen, wobei die zweite Seite der Wundkontaktschicht oder der Hydrogelmatrix in direktem Kontakt mit dem Polyurethanschaum steht.According to a further development of the invention, it can also be provided that the wound contact layer or the hydrogel matrix has openings which have a diameter of 0.5 to 5 mm. In particular, the wound contact layer or the hydrogel matrix has openings which have a diameter of 1 to 3 mm. The wound contact layer or the hydrogel matrix very particularly preferably has openings on the first side facing the wound that have a diameter of 1 to 3 mm have, wherein the second side of the wound contact layer or the hydrogel matrix is in direct contact with the polyurethane foam.
Es kann jedoch auch vorgesehen sein, dass zwischen der absorbierenden Schicht und der Wundkontaktschicht eine Übergangsschicht angeordnet ist. In dieser Ausführungsform weist eine erfindungsgemäße Wundauflage zwischen der Hydrogelmatrix und Polyurethanschaum eine Schicht auf, die beide Materialen umfasst. Diese Übergangsschicht kann ebenso wie die Wundkontaktschicht Kanäle, Öffnungen oder Löcher aufweisen. Falls die Übergangsschicht Kanäle, Öffnungen oder Löcher aufweist, sind gemäß einer weiter bevorzugten Ausführungsform diese Kanäle, Öffnungen oder Löcher mit Polyurethanschaum ausgefüllt. Weiterhin bevorzugt sind diese Kanäle, Öffnungen oder Löcher kongruent zu den Kanälen, Öffnungen oder Löchern der Wundkontaktschicht. Durch die Anordnung einer solchen Übergangsschicht kann eine Wundauflage bereitgestellt werden, die ein Laminat aus einem Polyurethanschaum und einer Hydrogelmatrix umfasst, das einen besonders festen Zusammenhalt zwischen der absorbierenden Schicht und der Wundkontaktschicht aufweist.However, it can also be provided that a transition layer is arranged between the absorbent layer and the wound contact layer. In this embodiment, a wound dressing according to the invention has a layer between the hydrogel matrix and polyurethane foam which comprises both materials. Like the wound contact layer, this transition layer can have channels, openings or holes. If the transition layer has channels, openings or holes, according to a further preferred embodiment, these channels, openings or holes are filled with polyurethane foam. Furthermore, these channels, openings or holes are preferably congruent to the channels, openings or holes in the wound contact layer. By arranging such a transition layer, a wound dressing can be provided which comprises a laminate of a polyurethane foam and a hydrogel matrix, which has a particularly firm cohesion between the absorbent layer and the wound contact layer.
Die erfindungsgemäßen Hydrogele sind für die Behandlung von Wunden geeignet. Die vorliegende Erfindung umfasst daher auch erfindungsgemäße Hydrogele zur Behandlung von Wunden. Insbesondere umfasst die vorliegende Erfindung Hydrogele zur Behandlung chronischer Wunden wie Dekubitus, Druck-Ulzera, Druckgeschwüre, Ulcus cruris venosum, venöse Ulzera, Ulcus cruris arteriosum, arterielle Ulzera, Wunden infolge von diabetischem Fußsyndrom, neuropathische Ulzera, aber auch Wunden in Folge von Autoimmunerkrankungen oder von Tumoren (exulzierende Tumore) oder von Strahlenschäden bei der Tumortherapie.The hydrogels according to the invention are suitable for the treatment of wounds. The present invention therefore also comprises hydrogels according to the invention for treating wounds. In particular, the present invention comprises hydrogels for the treatment of chronic wounds such as pressure ulcers, pressure ulcers, pressure ulcers, venous leg ulcers, venous ulcers, arterial leg ulcers, arterial ulcers, wounds as a result of diabetic foot syndrome, neuropathic ulcers, but also wounds as a result of autoimmune diseases or from tumors (ulcerating tumors) or from radiation damage during tumor therapy.
Erfindungsgemäße Hydrogele bzw. Wundauflagen, die diese enthalten, sind zur phasengerechten Wundtherapie geeignet, insbesondere zur Therapie von Wunden in der Granulationsphase und/oder der Epithelisierungsphase.Hydrogels or wound dressings according to the invention which contain them are suitable for phase-appropriate wound therapy, in particular for the therapy of wounds in the granulation phase and / or the epithelialization phase.
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Figur 1 : Eine erste erfindungsgemäße WundauflageFigure 1 : A first wound dressing according to the invention -
Figur 2 : Eine zweite erfindungsgemäße Wundauflage im QuerschnittFigure 2 : A second wound dressing according to the invention in cross section -
Figur 3 : Eine dritte erfindungsgemäße Wundauflage im QuerschnittFigure 3 : A third wound dressing according to the invention in cross section -
Figur 3a : Ein Teilausschnitt der dritten erfindungsgemäße Wundauflage im QuerschnittFigure 3a : A partial section of the third wound dressing according to the invention in cross section -
Figur 4 : Eine vierte erfindungsgemäße Wundauflage im QuerschnittFigure 4 : A fourth wound dressing according to the invention in cross section
Mit
Mit
Mit
Mit
- Beispiele 1-13: Herstellung der GeleExamples 1-13: Preparation of the gels
- (Beispiele 7-13 sind nicht erfindungsgemäß)(Examples 7-13 are not according to the invention)
Entsprechend der folgenden Tabelle 1 werden Mischungen aus Alkohol, demineralisertem Wasser und Natriumchlorid hergestellt.
In einem zweiten Schritt werden 3,465g Jeffamin bei 50°C geschmolzen und mit 3,135g demineralisiertem Wasser vermischt. Diese Menge Jeffamin enthält 3,31mmol reaktive Aminendgruppen. Die erhaltene Mischung wird mit 28,4g einer entsprechend der Tabelle hergestellten Alkohol-Mischung und 5,0 g Aquapol unter heftigem Rühren und Eiswasserkühlung vermischt. Diese Menge Aquapol enthält 3,84mmol reaktive Isocyanatendgruppen. Das molare Verhältnis reaktiver Isocyanatendgruppen zu reaktiven Amingruppen beträgt dabei jeweils 1,16. Die erhaltene Mischung wird ausgegossen und zu einem Gel mit einer Dicke von 3mm ausgestrichen.In a second step, 3.465 g of Jeffamine are melted at 50 ° C. and mixed with 3.135 g of demineralized water. This amount of Jeffamine contains 3.31 mmoles of reactive amine end groups. The mixture obtained is mixed with 28.4 g of an alcohol mixture prepared according to the table and 5.0 g of Aquapol with vigorous stirring and ice-water cooling. This amount of Aquapol contains 3.84mmol reactive isocyanate end groups. The molar ratio of reactive isocyanate end groups to reactive amine groups is 1.16 in each case. The mixture obtained is poured out and spread out to form a gel with a thickness of 3 mm.
Die Massen der in der Reaktion zur Herstellung der Gele eingesetzten Bestandteile weisen die in der Tabelle 2 angegebenen Verhältnisse bezogen auf die Gesamtmasse der eingesetzten Reaktanden auf:
Bei Beispiel Nr. 12 handelt es sich um ein Vergleichsbeispiel ohne mehrwertigen Alkohol.Example No. 12 is a comparative example without polyhydric alcohol.
Bei Beispiel Nr. 13 handelt es sich um ein Vergleichsbeispiel gemäß
Als Feuchtigkeitsverlust wird der Verlust an Gewicht über einen bestimmten Zeitraum bei einer definierten Temperatur beschrieben. Der Feuchtigkeitsverlust berechnet sich nach folgender Gleichung und wird in der Einheit g/g angegeben:
Für die Gele der Ausführungsbeispiele wurden die in der Tabelle 3 angegebenen Feuchtigkeitsverluste ermittelt:
Zur Messung der Absorptionskapazität werden Gelproben mit Durchmesser ∅ 5 cm ausgestanzt. Anschließend werden sie in ein Becherglas mit V = 300 ml deionisiertem Wasser gegeben. Daraufhin werden sie in bestimmten Zeitabständen erneut gewogen. Die Berechnung der Absorptionskapazität erfolgt nach folgender Gleichung und wird in der Einheit g/g angegeben:
Für die Gele der Ausführungsbeispiele wurden die in der Tabelle 4 angegebenen Absorptionskapazitäten ermittelt:
Der Begriff Adhäsionskraft beschreibt die Fähigkeit eines Klebstoffs an einer Oberfläche zu haften. Sie entspricht der Kraft, die notwendig ist, um einen mit der Geloberfläche in Kontakt geratenen Körper von dieser Oberfläche zu lösen, und wird mit Hilfe einer statischen Material-Prüfmaschine Zwick 010 ermittelt. Die Prüfungen werden bei einer Standardtemperatur von T = 23 °C und einer relativen Luftfeuchtigkeit von 50 %rh durchgeführt. Die Gele müssen für 24 Stunden vor der Prüfung unter den Prüfbedingungen konditioniert werden. Für jede Messung werden jeweils drei Proben mit einer Größe von jeweils 5 cm x 5 cm aus den Gelen ausgestanzt. Die Proben werden mit der wundabgewandten Seite mit einem doppelseitigen Klebeband auf einem horizontal beweglichen Schlitten befestigt. Die Anfahrgeschwindigkeit des Schlittens beträgt 100 mm/min, die Kontaktzeit mit der Geloberfläche 2 s, die Abzugsgeschwindigkeit des Schlittens 400 mm/min. Der Prüfkörper (Gewicht = 0,245 N) bewegt sich abwärts, bis dieser mit der Oberfläche des Gels in Kontakt tritt, wo er für eine Zeit von t = 2 s verweilt. Nach dieser Kontaktzeit bewegt sich der Prüfkörper nach oben und misst die Kraft, die zum Lösen des Körpers von der Geloberfläche notwendig ist.The term adhesive force describes the ability of an adhesive to adhere to a surface. It corresponds to the force that is necessary to detach a body that has come into contact with the gel surface from this surface and is determined with the aid of a static materials testing machine Zwick 010. The tests are carried out at a standard temperature of T = 23 ° C and a relative humidity of 50% rh. The gels must be conditioned under the test conditions for 24 hours before the test. For each measurement, three samples each with a size of 5 cm x 5 cm are punched out of the gels. The samples are attached to the side facing away from the wound with double-sided adhesive tape on a horizontally movable slide. The approach speed of the slide is 100 mm / min, the contact time with the gel surface 2 s, the withdrawal speed of the slide 400 mm / min. The test body (weight = 0.245 N) moves downwards until it comes into contact with the surface of the gel, where it remains for a time of t = 2 s. After this contact time, the test body moves upwards and measures the force that is necessary to detach the body from the gel surface.
Die Tests auf Zellkompatibilität wurden gemäß DIN EN ISO 10993-5 und den Verfahrensanweisungen der Abteilung für Funktionswerkstoffe der Medizin und der Zahnheilkunde: BioLab 973302, 042901, 964702 und 964805 durchgeführt und umfassen Messungen des Zellwachstums, der Stoffwechselaktivität und des Proteingehalts.The tests for cell compatibility were carried out in accordance with DIN EN ISO 10993-5 and the procedural instructions of the Department of Functional Materials in Medicine and Dentistry: BioLab 973302, 042901, 964702 and 964805 and include measurements of cell growth, metabolic activity and protein content.
Die Hydrogele wurden steril in Petrischalen geliefert. Zur Prüfung wurden je 0,1 g/ml Kulturmedium der Proben eingewogen.The hydrogels were delivered sterile in Petri dishes. For the test, 0.1 g / ml culture medium each of the samples was weighed out.
Die Zellaktivität, die Zellzahl sowie die Proteinkonzentration wurden pro Probe dreimal in je vier Parallelansätzen untersucht. Die Eluationszeit betrug 48 h, die Inkubation der Zellen mit den Eluaten ebenso 48 h.The cell activity, the number of cells and the protein concentration were examined three times per sample in four parallel batches each. The elution time was 48 hours and the incubation of the cells with the eluates was also 48 hours.
Als Zelllinie wurden L 929 CC1 Mausfibroblasten, American Type Culture Collection, Rockeville Maryland USA verwendet.L 929 CC1 mouse fibroblasts, American Type Culture Collection, Rockeville Maryland USA were used as the cell line.
Als Kulturmedium wurde DMEM (Dulbecco's mod. Eagle Medium) nach VA BioLab 042901 zur Vorkultur und Eluation verwendet.DMEM (Dulbecco's mod. Eagle Medium) according to VA BioLab 042901 was used as the culture medium for preculture and elution.
Als Negativkontrolle wurde Polystyrol der Firma Nunc GmbH & Co KG, Wiesbaden verwendet. Als Positivkontrolle wurden Vekoplan KT PVC Platten der Firma König GmbH, Wendelstein verwendet.Polystyrene from Nunc GmbH & Co KG, Wiesbaden, was used as the negative control. Vekoplan KT PVC sheets from König GmbH, Wendelstein, were used as positive controls.
Pro Probe wurden drei Eluate aus je einem Hydrogel getestet, die an unterschiedlichen Versuchstagen angesetzt wurden. Hierzu wurden die Hydrogele in den Petrischalen mit einem sterilen Skalpell mittig halbiert und in ein steriles 50 ml Reaktionsgefäß überführt. Pro 0,1 g Probe wurde 1 ml Eluationsmedium zu den Hydrogelen zugegeben und diese dann für 48 h bei 37 °C und 5 % CO2 im Inkubator eluiert. Um vorhandene Schwebstoffe aus den Eluaten zu entfernen, wurden die Proben nach der Inkubation für 5 min bei 4000 rpm zetrifugiert und durch einen Filter (Porengröße 0,2 µm) filtriert.Three eluates from one hydrogel each, which were prepared on different test days, were tested per sample. For this purpose, the hydrogels in the Petri dishes were cut in half with a sterile scalpel and transferred to a sterile 50 ml reaction vessel. 1 ml of elution medium was added to the hydrogels per 0.1 g of sample and these were then eluted in the incubator at 37 ° C. and 5% CO2. In order to remove any suspended matter from the eluates, the samples were centrifuged for 5 min at 4000 rpm after incubation and filtered through a filter (pore size 0.2 μm).
Die Zellen wurden in der Konzentration 50.000 Zellen/ml ausgesät, die Vorkultivierung erfolgte bei 37 °C und 5 % CO2 für 24 h. Anschließend wurde das bei der Aussaat zugegebene DMEM Medium abgezogen und die Zellen mit je 1 ml Eluat in der Konzentration 100 % bedeckt. Als Negativkontrolle wurde DMEM Medium 48 h in einem 50 ml Falconröhrchen wie die Proben inkubiert, als Positivkontrolle diente das Eluat der Plastic Discs in der Konzentration 100 %. Nach 48 stündiger Inkubation wurden die Zellaktivität, die Zellzahl und der Gesamtproteingehalt bestimmt.The cells were sown at a concentration of 50,000 cells / ml, preculturing took place at 37 ° C. and 5% CO2 for 24 h. The DMEM medium added during sowing was then drawn off and the cells were each covered with 1 ml of eluate at a concentration of 100%. As a negative control, DMEM medium was incubated for 48 h in a 50 ml Falcon tube like the samples; the eluate of the plastic discs in a concentration of 100% served as a positive control. After 48 hours of incubation, the cell activity, the number of cells and the total protein content were determined.
Die Zellzählung erfolgte nach enzymatischer Ablösung der Zellen mittels Accutase mit Hilfe des Zellzählers.The cells were counted after enzymatic detachment of the cells by means of Accutase with the aid of the cell counter.
Die Prüfung der Vitalität erfolgt mit Tetrazoliumsalz, WST 1, Fa. Roche Diagnostics GmbH Mannheim, nach Angabe des Herstellers. WST 1 wird durch die Succinatdehydrogenase (Enzym des Citronensäurezyklus) in den Mitochondrien der stoffwechselaktiven Zellen zum farbigen Formazan umgesetzt und photometrisch vermessen. Die Absorptionswerte (OD), bei 450 nm und 620 nm bestimmt, korrelieren mit der Atmungsaktivität der kultivierten Zellen.The vitality is checked with tetrazolium salt, WST 1, Roche Diagnostics GmbH Mannheim, according to the manufacturer's instructions. WST 1 is converted into colored formazan by the succinate dehydrogenase (enzyme of the citric acid cycle) in the mitochondria of the metabolically active cells and measured photometrically. The absorption values (OD), determined at 450 nm and 620 nm, correlate with the respiratory activity of the cultured cells.
Die Prüfung des Proteingehaltes erfolgt mit dem DC Protein Assay, Fa. BIO-RAD GmbH München, nach Angabe des Herstellers. Die Proteinbestimmung nach Lowry basiert auf der Reduktion von Cu(ll) zu Cu(l) durch die aromatischen Tyrosin- Tryptophanreste von Proteinen. Der Kupfer-Protein-Komplex reduziert in einem weiteren Schritt ein Phosphormolybdänsäure-Phosphorwolframat-Reagenz zu Molybdän bzw. Wolframblau. Die Extinktion dieser intensiven blauen Färbung wird photometrisch bei 750 nm gemessen. Durch das Mitführen einer Standardreihe kann die Proteinkonzentration bestimmt werden.The protein content is tested using the DC Protein Assay, from BIO-RAD GmbH Munich, according to the manufacturer's instructions. The protein determination according to Lowry is based on the reduction of Cu (II) to Cu (I) by the aromatic tyrosine-tryptophan residues of proteins. The copper-protein complex is reduced in a further step Phosphomolybdic acid phosphotungstate reagent for molybdenum or tungsten blue. The extinction of this intense blue color is measured photometrically at 750 nm. The protein concentration can be determined by carrying a standard series.
Die Einteilung der Wertungsbereiche für Akzeptanz und Auswertung erfolgte in Anlehnung an DIN EN ISO 7405 und dem Begriff Inhibitionsdosis (ID 50: Dosis bei welcher 50% der Zellen im Wachstum gehemmt sind) (Literatur:
Als stark verminderte Stoffwechselaktivität wird eine Zellaktivität von 0-29 %, als mäßig verminderte Stoffwechselaktivität eine Zellaktivität von 30-59 % und als schwach verminderte Stoffwechselaktivität eine Zellaktivität von 60-79 % im Vergleich zur Kontrolle charakterisiert. Zellaktivitätsraten zwischen 80 und 100% indizieren eine nicht verminderte Stoffwechselaktivität.A cell activity of 0-29% is characterized as a strongly reduced metabolic activity, a cell activity of 30-59% as a moderately reduced metabolic activity and a cell activity of 60-79% compared to the control as a weakly reduced metabolic activity. Cell activity rates between 80 and 100% indicate a non-reduced metabolic activity.
Als stark reduzierter Proteingehalt wird eine Proteinkonzentration von 0-34%, als mäßig reduzierter Proteingehalt eine Proteinkonzentration von 35-69 % im Vergleich zur Kontrolle charakterisiert. Proteinkonzentrationen zwischen 70 und 100 % indizieren einen nicht reduzierten Proteingehalt.A protein concentration of 0-34% is characterized as a strongly reduced protein content, and a protein concentration of 35-69% as a moderately reduced protein content compared to the control. Protein concentrations between 70 and 100% indicate a non-reduced protein content.
Für die Gele der Ausführungsbeispiele wurden die in der Tabelle 5 angegebenen Zellkompatibilitäten ermittelt:
Claims (13)
- Aqueous hydrogel for the treatment of wounds obtainable by reacting an a) amine-terminated prepolymer containing polyalkylene oxide units with an b) isocyanate-terminated prepolymer containing polyalkylene oxide units, the reaction taking place in the presence of a polyhydric alcohol, except propylene glycol, and in the presence of water and, based on the total mass of all reactants,the sum total of the masses of amine-terminated prepolymer and isocyanate-terminated prepolymer being 10-30% by weight of the total mass of all reactants andthe mass of the polyhydric alcohol, except propylene glycol, being 5-35% by weight of the total mass of all reactants andthe mass of the water used being at least 40% by weight of the total mass of all reactants,the molar ratio of reactive isocyanate end groups to reactive amine end groups being 1.0 to 2.0, preferably 1.0 to 1.5, characterized in that the polyhydric alcohol is glycerol.
- Aqueous hydrogel according to Claim 1, characterized in that the hydrogel is obtainable by reacting an a) amine-terminated prepolymer containing polyethylene oxide units and/or polypropylene oxide units with an b) at least three-armedly branched isocyanate-terminated prepolymer containing polyethylene oxide units and/or polypropylene oxide units.
- Aqueous hydrogel according to either of the preceding claims, characterized in that the weight ratio of polyethylene oxide units to polypropylene oxide units both in the amine-terminated prepolymer and in the isocyanate-terminated prepolymer is 3:1 to 7:1.
- Aqueous hydrogel according to any of the preceding claims, characterized in that glycerol is used in an amount of 10-25% by weight.
- Aqueous hydrogel according to any of the preceding claims, characterized in that glycerol is used in an amount of 15-25% by weight.
- Aqueous hydrogel according to any of the preceding claims, characterized in that the hydrogel matrix additionally comprises 0.5-1.5% by weight of a salt selected from the group consisting of sodium chloride, potassium chloride, magnesium chloride and/or calcium chloride.
- Wound dressing comprising a backing layer and a layer comprising an aqueous hydrogel matrix according to any of the preceding claims.
- Wound dressing according to Claim 7, characterized in that the wound dressing additionally comprises an absorbent layer which is arranged between the backing layer and the layer comprising an aqueous hydrogel matrix according to any of Claims 1-6.
- Wound dressing according to either of Claims 7 and 8, characterized in that the layer comprising an aqueous hydrogel matrix according to any of Claims 1-6 is continuous.
- Wound dressing according to any of Claims 7 to 9, characterized in that the layer comprising an aqueous hydrogel matrix according to any of Claims 1-6 comprises holes, openings or channels.
- Aqueous hydrogel according to any of Claims 1 to 6 for use in the treatment of chronic wounds.
- Aqueous hydrogel according to any of Claims 1 to 6 for the concentration of wound healing-promoting growth factors.
- Aqueous hydrogel according to any of Claims 1 to 6 for the treatment of wounds in the granulation and/or epithelialization phase.
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DE102016125534.3A DE102016125534A1 (en) | 2016-12-23 | 2016-12-23 | Hydrous hydrogels for wound care |
PCT/EP2017/084043 WO2018115257A1 (en) | 2016-12-23 | 2017-12-21 | Water-containing hydrogels for dressing wounds |
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EP3558400A1 EP3558400A1 (en) | 2019-10-30 |
EP3558400B1 true EP3558400B1 (en) | 2021-11-10 |
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EP17825217.7A Active EP3558400B1 (en) | 2016-12-23 | 2017-12-21 | Water-containing hydrogels for dressing wounds |
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US (1) | US11065361B2 (en) |
EP (1) | EP3558400B1 (en) |
CN (1) | CN110114097A (en) |
DE (1) | DE102016125534A1 (en) |
RU (1) | RU2753519C2 (en) |
WO (1) | WO2018115257A1 (en) |
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DE102018102126A1 (en) * | 2018-01-31 | 2019-08-01 | Lohmann & Rauscher Gmbh & Co. Kg | wound dressing |
DE102019128569A1 (en) | 2019-10-23 | 2021-04-29 | Julius-Maximilians-Universität Würzburg | Wound dressing comprising a wound contact layer with a web-like coating for directed cell migration |
DE102020134827A1 (en) * | 2020-12-23 | 2022-06-23 | Paul Hartmann Ag | Hydrogel for treatment of pressure sores |
WO2022226857A1 (en) * | 2021-04-29 | 2022-11-03 | 美丽康生技股份有限公司 | Wet dressing for tattoo color protection and using method therefor |
DE102021118759A1 (en) * | 2021-07-20 | 2023-01-26 | Paul Hartmann Ag | Radiation crosslinking and sterilization of silicone |
EP4134107A1 (en) | 2021-08-12 | 2023-02-15 | Paul Hartmann AG | Wound dressing comprising a hydrogel layer and a wound contact layer comprising hyaluronic acid |
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JPS6045522B2 (en) * | 1982-12-08 | 1985-10-09 | 憲司 中村 | cosmetic tools |
EP0411063B1 (en) * | 1988-09-26 | 1996-10-23 | Paul Hartmann Aktiengesellschaft | Wound dressing |
US5051661A (en) | 1989-01-09 | 1991-09-24 | Lee Sang Woo | Protective circuit for fluorescent lamp stabilizer |
US5059424A (en) | 1989-11-01 | 1991-10-22 | Ndm Acquisition Corp. | Hydrogel wound dressing product |
US5204110A (en) * | 1990-05-02 | 1993-04-20 | Ndm Acquisition Corp. | High absorbency hydrogel wound dressing |
RU2053795C1 (en) * | 1992-11-02 | 1996-02-10 | Предприятие "БИАМ" - товарищество с ограниченной ответственностью | Composition for dressing material |
NZ250994A (en) | 1993-05-27 | 1995-09-26 | Ndm Acquisition Corp | Wound dressing comprising a hydrogel layer bound to a porous backing layer which is bound to a thin film layer by adhesive |
US6803420B2 (en) | 2001-05-01 | 2004-10-12 | Corium International | Two-phase, water-absorbent bioadhesive composition |
US7247692B2 (en) * | 2004-09-30 | 2007-07-24 | Johnson & Johnson Vision Care, Inc. | Biomedical devices containing amphiphilic block copolymers |
RU73198U1 (en) * | 2008-01-09 | 2008-05-20 | Владислав Александрович Попов | HYDROGEL MEDICINAL COATING FOR RAS |
DE102008031183A1 (en) * | 2008-07-03 | 2010-01-07 | Paul Hartmann Ag | wound dressing |
DE102008031182A1 (en) | 2008-07-03 | 2010-01-07 | Paul Hartmann Ag | Wound dressing with hydrogel matrix |
RU2424825C2 (en) * | 2009-07-02 | 2011-07-27 | Общество с ограниченной ответственностью "Научно-производственное объединение "Локус" | Gel-like coating from elastic foam-polyurethane for closing wounds of various etiology |
RU2422133C1 (en) * | 2009-11-26 | 2011-06-27 | Федеральное государственное унитарное предприятие "Государственный научно-исследовательский институт особо чистых биопрепаратов" Федерального медико-биологического агентства | Hydrophylic gel, method of its obtaining (versions), wound covering and based on it bandage means |
EP2338528B1 (en) | 2009-12-24 | 2013-05-29 | Paul Hartmann AG | Hydrogel matrix with increased absorption capacity for liquids |
EP2338529B1 (en) | 2009-12-24 | 2013-05-29 | Paul Hartmann AG | Hydrogel matrix with improved adhesive characteristics |
US9574109B2 (en) * | 2010-02-18 | 2017-02-21 | Dow Corning Corporation | Surface-modified hydrogels and hydrogel microparticles |
EP2767293A1 (en) * | 2013-02-19 | 2014-08-20 | Paul Hartmann AG | Composition for the accelerated wound healing of damaged tissue |
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2017
- 2017-12-21 CN CN201780080109.2A patent/CN110114097A/en active Pending
- 2017-12-21 US US16/471,245 patent/US11065361B2/en active Active
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- 2017-12-21 RU RU2019122990A patent/RU2753519C2/en active
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US11065361B2 (en) | 2021-07-20 |
DE102016125534A1 (en) | 2018-06-28 |
WO2018115257A1 (en) | 2018-06-28 |
CN110114097A (en) | 2019-08-09 |
EP3558400A1 (en) | 2019-10-30 |
RU2019122990A (en) | 2021-01-25 |
RU2753519C2 (en) | 2021-08-17 |
RU2019122990A3 (en) | 2021-01-25 |
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